The interrater reliability of a validated bronchiolitis severity assessment tool

Paul Walsh, Adrian Gonzales, Amina Satar, Stephen J. Rothenberg

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


BACKGROUND: We previously constructed and tested a bronchiolitis severity assessment tool in 2 independent hospitals. The model uses age, work of breathing, dehydration and tachycardia to successfully predict disease severity. OBJECTIVE: To prospectively measure the interrater reliability of a bronchiolitis severity assessment tool and of its component variables. DESIGN: Prospective observational survey. SETTING: A county teaching hospital emergency department serving a mixed urban and rural population with an emergency medicine residency program in 2-3-4 format. SUBJECTS: Thirty-two physicians evaluated a convenience sample of children aged less than 18 months presenting to the emergency department with a clinical diagnosis of bronchiolitis during a single season. METHODS: Two physicians independently examined each patient. Each physician completed a physical examination template that included the variables used in the severity assessment tool. Interrater agreement was measured for the variables work of breathing and dehydration and for the tool as a whole using a weighted κ statistic. RESULTS: One hundred and forty-six cases were enrolled. Twenty-five were dropped for incomplete data collection. The actual weighted agreement on overall classification was 92%; expected, 73%, κ = 0.676; P < 0.0001. The actual weighted agreement for dehydration was at 95%; expected, 92%, κ = 0.305; P = 0.0001. The agreement for work of breathing was 95%; expected, 86%; κ = 0.611; P < 0.0001. The overall model showed better interrater reliability than its individual components. CONCLUSIONS: Overall interrater reliability for this bronchiolitis severity assessment tool is substantial.

Original languageEnglish (US)
Pages (from-to)316-320
Number of pages5
JournalPediatric Emergency Care
Issue number5
StatePublished - May 2006
Externally publishedYes


  • Bronchiolitis
  • Interrater reliability
  • Severity assessment tool

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nursing(all)
  • Emergency Medicine


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