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Academia Mexicana de Neurología, A.C.

2008, Number 3

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Rev Mex Neuroci 2008; 9 (3)

Reproducibility of the Glasgow Coma Scale in a University Hospital

Tapia-Pérez JH, Sánchez-Aguilar M, Hernández-Sierra F, Torres-Corzo JG

Language: Spanish
References: 14
Page: 180-183
PDF size: 48.66 Kb.


ABSTRACT

Introduction: The medicine based in evidence implies the integration to the clinical activity, the best external clinical evidence obtained from clinical research. The application of systematized scales permits a better communication between centers and studies. Glasgow Coma Scale is useful for evaluation of conscience state, but variability inter and intra-observer is frequent. We present a study of concordance with Glasgow Coma scale for determination of reproducibility of the subcategories in several academic degrees. Material and methods: Eight videos were recorded from patients with head injury for evaluating concordance between physicians related with the application of Glasgow Scale. Two neurosurgeons, one neurologist, two residents of neurology and four residents of surgery in emergencies were evaluated. Intra-class correlation coefficient (ICC) and weighted kappa were calculated. Results: We obtained ICC average of 0.95, 0.78, 0.89, and 0.92 (ocular, verbal, motor and sum). The weighted κw by segments was 0.87, 0.71, 0.84, and global 0.81 respectively. Absolute agreement of ICC was 0.94, 0.78, 0.82, and 0.91 each item. Conclusion: The concordance was more than acceptable and the motor component was the weakest. The systematic evaluation of health care personal in order to determinate reliability is recommendable, also the application of statistic methods for evaluation of clinical skills of physicians in training.


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