Muro, Florida; Mosha, Neema; Hildenwall, Helena; Mtei, Frank; Harrison, Nicole; Schellenberg, David; Olomi, Raimos; Reyburn, Hugh; Todd, Jim; (2016) Variability of respiratory rate measurements in children suspected with non-severe pneumonia in north-east Tanzania. Tropical medicine & international health, 22 (2). pp. 139-147. ISSN 1360-2276 DOI: https://doi.org/10.1111/tmi.12814
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Abstract
OBJECTIVE: Measurement of respiratory rate is an important clinical sign in the diagnosis of pneumonia but suffers from interobserver variation. Here, we assess the use of video recordings as a quality assurance tool that could be useful both in research and in training of staff. METHODS: Respiratory rates (RR) were recorded in children aged 2-59 months presenting with cough or difficulty breathing at two busy outpatient clinics in Tanzania. Measurements were repeated at 10-min intervals in a quiet environment with simultaneous video recordings that were independently reviewed by two paediatricians. RESULTS: Eight hundred and fifty-nine videos were sent to two paediatricians; 148 (17.2%) were considered unreadable by one or both. For the 711 (82.8%) videos that were readable by both paediatricians, there was perfect agreement for the presence of raised RR with a kappa value (κ) of 0.85 (P < 0.001); and in 476 (66.9%) cases, both paediatricians agreed on the RR within 2 breaths per minute (±2 bpm). A reported illness of 5 days or more was associated with unreadable video recordings (OR = 3.44, CI: 1.5-6.08; P < 0.001). The multilevel model showed that differences between observers accounted for only 13% of the variability in RR. CONCLUSION: Video recordings are reliable tools for quality assurance of RR measurements in children with suspected pneumonia. Videos with a clear view of respiratory movements may also be useful in training primary healthcare staff.
Item Type | Article |
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Faculty and Department |
Faculty of Infectious and Tropical Diseases > Dept of Disease Control Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) |
Research Centre | Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 27862739 |
ISI | 394652100003 |
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