Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. Export

@article{citeulike:6083247, abstract = {To investigate whether the Glasgow Coma Scale (GCS) can be used reliably and accurately by inexperienced observers, ratings made by observers grouped by level of experience were examined for within-group interobserver disagreements and for discrepancies with scores given by an expert. The GCS was used accurately by experienced and highly trained users, but inexperienced users made consistent errors. The errors were such that they would not be detectable by studies that examine only interobserver agreement, and they were substantial, averaging in some cases more than one point on the four-point and five-point scales of the GCS. Also, the error rates were highest at the intermediate levels of consciousness, for which the detection of changes in condition is vital. The findings support the continued use of the GCS by appropriately qualified personnel, but call into question much of the conventional wisdom about its reliability when used by untrained or inexperienced staff. The findings also suggest that interobserver comparisons are insufficient for establishing the viability of the GCS.}, author = {Rowley, G. and Fielding, K.}, citeulike-article-id = {6083247}, citeulike-linkout-0 = {http://view.ncbi.nlm.nih.gov/pubmed/1671900}, citeulike-linkout-1 = {http://www.hubmed.org/display.cgi?uids=1671900}, day = {2}, issn = {0140-6736}, journal = {Lancet}, keywords = {accuracy, consciousness, gcs, loc, reliability}, month = {March}, number = {8740}, pages = {535--538}, posted-at = {2009-11-07 18:59:21}, priority = {2}, title = {Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users.}, url = {http://view.ncbi.nlm.nih.gov/pubmed/1671900}, volume = {337}, year = {1991} }

TY - JOUR ID - citeulike:6083247 L3 - citeulike-article-id:6083247 N2 - To investigate whether the Glasgow Coma Scale (GCS) can be used reliably and accurately by inexperienced observers, ratings made by observers grouped by level of experience were examined for within-group interobserver disagreements and for discrepancies with scores given by an expert. The GCS was used accurately by experienced and highly trained users, but inexperienced users made consistent errors. The errors were such that they would not be detectable by studies that examine only interobserver agreement, and they were substantial, averaging in some cases more than one point on the four-point and five-point scales of the GCS. Also, the error rates were highest at the intermediate levels of consciousness, for which the detection of changes in condition is vital. The findings support the continued use of the GCS by appropriately qualified personnel, but call into question much of the conventional wisdom about its reliability when used by untrained or inexperienced staff. The findings also suggest that interobserver comparisons are insufficient for establishing the viability of the GCS. IS - 8740 JF - Lancet SN - 0140-6736 EP - 538 TI - Reliability and accuracy of the Glasgow Coma Scale with experienced and inexperienced users. VL - 337 SP - 535 KW - accuracy KW - consciousness KW - gcs KW - loc KW - reliability AU - Rowley, G AU - Fielding, K PY - 1991/03/02/ UR - http://view.ncbi.nlm.nih.gov/pubmed/1671900 ER -