Interrater Reliability and Accuracy of Clinicians and Trained Research Assistants Performing Prospective Data Collection in Emergency Department Patients With Potential Acute Coronary Syndrome
, 30 January 2009
Carlos O. Cruz, Emily B. Meshberg, Frances S. Shofer, Christine M. McCusker, Anna Marie Chang, Judd E. Hollander
Annals of Emergency Medicine
July 2009 (Vol. 54, Issue 1, Pages 1-7) Abstract |
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Valid clinical research requires high-quality data collection. Physicians are commonly considered the standard by which valid prospective data are obtained.
What question this study addressed
This study determined whether non–medically trained research assistants could reliably collect subjective historical data from emergency department patients with chest pain.
What this study adds to our knowledge
This prospective comparative study included 33 research assistants, 39 physicians, and 143 patients. Research assistants demonstrated fair to excellent reliability (as defined by crude agreement and kappa) when obtaining cardiac histories and cardiac risk factors.
How this might change clinical practice
The results of this study will not change clinical practice. They do, however, provide evidence to support the use of trained research assistants for the collection of certain types of clinical data.
University of California, Los Angeles, CA
Section editors: Tyler W. Barrett, MD; David L. Schriger, MD, MPH
SEE RELATED ARTICLE, P. 1.
Editor's Note: This 10th installment of Annals of Emergency Medicine Journal club departs slightly from previous installments by focusing on a single methodological issue, the measurement of reliability. We use this issue's Cruz et al article as a jumping-off point for our discussion. This bimonthly feature seeks to improve the critical appraisal skills of emergency physicians and other interested readers through a guided critique of actual Annals of Emergency Medicine articles. Each Journal Club will pose questions that encourage readers—be they clinicians, academics, residents, or medical students—to critically appraise the literature.
During a 2- to 3-year cycle, we plan to ask questions that cover the main topics in research methodology and critical appraisal of the literature. To do this, we will select articles that use a variety of study designs and analytic techniques. These may or may not be the most clinically important articles in a specific issue, but they are articles that serve the mission of covering the clinical epidemiology curriculum. Journal Club entries are published in 2 phases. In the first phase, a list of questions about the article is published in the issue in which the article appears. Questions are rated “novice,” () “intermediate,” () and “advanced” () so that individuals planning a journal club can assign the right question to the right student. The answers to this journal club will be published in the December 2009 issue. US residency directors will have immediate access to the answers through the Council of Emergency Medicine Residency Directors Share Point Web site. International residency directors can gain access to the questions by going to http://www.emergencymedicine.ucla.edu/annalsjc/ and following the directions. Thus, if a program conducts its journal club within 5 months of the publication of the questions, no one will have access to the published answers except the residency director. The purpose of delaying the publication of the answers is to promote discussion and critical review of the literature by residents and medical students and discourage regurgitation of the published answers.
It is our hope that the Journal Club will broaden Annals of Emergency Medicine's appeal to residents and medical students. We are interested in receiving feedback about this feature. Please e-mail journalclub@acep.org with your comments.