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      Providing quality data in health care - almost perfect inter-rater agreement in the Norwegian tonsil surgery register

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          Abstract

          Background

          The Norwegian Tonsil Surgery Register (NTSR) was launched in January 2017. The purpose of the register is to present data on tonsil surgery to facilitate improvements in patient care. Data used for evaluating the quality of medical care needs to be of high reliability. This study aims to assess the inter-rater reliability (IRR) of the variables reported to the register by medical professionals.

          Methods

          The study population consists of the first 137 tonsil surgery patients who were included in the NTSR at St. Olav’s University Hospital in Trondheim. An experienced rater completed the register’s paper form for all 137 patients based on their electronic medical records, blinded for the data already in the register. To assess the inter-rater reliability between the register and the external rater, we calculated observed agreement, Cohen’s kappa and Gwet’s AC 1 coefficients with 95% confidence intervals.

          Results

          All tested variables in the NTSR have almost perfect reliability except for the variable for the cold steel technique, which had a substantial to almost perfect reliability. The inter-rater agreement was substantial to almost perfect for every variable, with substantial (kappa/AC 1 > 0.61) to almost perfect (kappa/AC 1 > 0.81) agreement for all the examined variables.

          Conclusion

          This study shows that the reliability of the NTSR is high for all variables registered by the professionals at the hospital immediately after surgery.

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          Most cited references10

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          Interrater agreement and interrater reliability: key concepts, approaches, and applications.

          Evaluations of interrater agreement and interrater reliability can be applied to a number of different contexts and are frequently encountered in social and administrative pharmacy research. The objectives of this study were to highlight key differences between interrater agreement and interrater reliability; describe the key concepts and approaches to evaluating interrater agreement and interrater reliability; and provide examples of their applications to research in the field of social and administrative pharmacy. This is a descriptive review of interrater agreement and interrater reliability indices. It outlines the practical applications and interpretation of these indices in social and administrative pharmacy research. Interrater agreement indices assess the extent to which the responses of 2 or more independent raters are concordant. Interrater reliability indices assess the extent to which raters consistently distinguish between different responses. A number of indices exist, and some common examples include Kappa, the Kendall coefficient of concordance, Bland-Altman plots, and the intraclass correlation coefficient. Guidance on the selection of an appropriate index is provided. In conclusion, selection of an appropriate index to evaluate interrater agreement or interrater reliability is dependent on a number of factors including the context in which the study is being undertaken, the type of variable under consideration, and the number of raters making assessments. Copyright © 2013 Elsevier Inc. All rights reserved.
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            A goodness-of-fit approach to inference procedures for the kappa statistic: confidence interval construction, significance-testing and sample size estimation.

            We propose a new procedure for constructing a confidence interval about the kappa statistic in the case of two raters and a dichotomous outcome. The procedure is based on a chi-square goodness-of-fit test as applied to a model frequently used for clustered binary data. The procedure provides coverage levels that are accurate in samples of smaller size than those required for other procedures. The procedure also has use for significance-testing and the planning of corresponding sample size requirements.
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              Post-tonsillectomy haemorrhage rates are related to technique for dissection and for haemostasis. An analysis of 15734 patients in the National Tonsil Surgery Register in Sweden.

              To analyse post-tonsillectomy haemorrhage (PTH) rates related to technique for dissection and haemostasis.
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                Author and article information

                Contributors
                +47 92266096 , Siri.wennberg@stolav.no
                Lasse.A.Karlsen@stolav.no
                joacim@stalfors.se
                mette.bratt@stolav.no
                vegard.bugten@ntnu.no
                Journal
                BMC Med Res Methodol
                BMC Med Res Methodol
                BMC Medical Research Methodology
                BioMed Central (London )
                1471-2288
                7 January 2019
                7 January 2019
                2019
                : 19
                : 6
                Affiliations
                [1 ]ISNI 0000 0004 0627 3560, GRID grid.52522.32, Department of Medical Quality Registries, , St. Olav’s University Hospital, MTFS, ; Torgarden, P.O. Box 3250, 7006 Trondheim, Norway
                [2 ]ISNI 0000 0004 1773 3278, GRID grid.415670.1, Sheikh Khalifa Medical City, ; Ajman, United Arab Emirates
                [3 ]ISNI 0000 0000 9919 9582, GRID grid.8761.8, Institute of Clinical Sciences, , Sahlgrenska Academy at the University of Gothenburg, ; P.O. Box 426, 405 30 Göteborg, Sweden
                [4 ]ISNI 0000 0004 0627 3560, GRID grid.52522.32, Department of Otorhinolaryngology, Head and Neck Surgery, , St. Olav’s University Hospital, ; Sluppen, P.O. Box 3250, 7006 Trondheim, Norway
                [5 ]ISNI 0000 0001 1516 2393, GRID grid.5947.f, Department of Neuromedicine and Movement Science, , Norwegian University of Science and Technology, ; 7006 Trondheim, Norway
                Author information
                http://orcid.org/0000-0003-1634-584X
                Article
                651
                10.1186/s12874-018-0651-2
                6323706
                30616535
                db107499-11a6-412b-b378-64184de71fe5
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 September 2018
                : 20 December 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Medicine
                data quality,medical quality register,tonsil surgery,chronic tonsillitis,tonsillectomy,tonsillotomy

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