A1 Refereed original research article in a scientific journal

The reliability and accuracy of operational system data in a nationwide helicopter emergency medical services mission database




AuthorsHeino A, Iirola T, Raatiniemi L, Nurmi J, Olkinuora A, Laukkanen-Nevala P, Virkkunen I, Tommila M

PublisherBMC

Publication year2019

JournalBMC Emergency Medicine

Journal name in sourceBMC EMERGENCY MEDICINE

Journal acronymBMC EMERG MED

Article number53

Volume19

Issue1

Number of pages6

ISSN1471-227X

eISSN1471-227X

DOIhttps://doi.org/10.1186/s12873-019-0265-y

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/42714259


Abstract
Aim The aim of this study was to evaluate the reliability and accuracy of documentation in FinnHEMS database, which is a nationwide helicopter emergency service (HEMS) clinical quality registry. Methods This is a nationwide study based on written fictional clinical scenarios. Study subjects were HEMS physicians and paramedics, who filled in the clinical quality registry based on the clinical scenarios. The inter-rater -reliability of the collected data was analyzed with percent agreement and free-marginal multi-rater kappa. Results Dispatch coding had a percent agreement of 91% and free-marginal multi-rater kappa value of 0.83. Coding for transportation or mission cancellation resulted in an agreement of 84% and free-marginal kappa value of 0.68. An agreement of 82% and a kappa value of 0.73 for dispatcher coding was found. Mission end, arrival at hospital and HEMS unit dispatch -times had agreements from 80 to 85% and kappa values from 0.61 to 0.73. The emergency call to dispatch centre time had an agreement of 71% and kappa value of 0.56. The documentation of pain had an agreement of 73% on both the first and second measurements. All other vital parameters had less than 70% agreement and 0.40 kappa value in the first measurement. The documentation of secondary vital parameter measurements resulted in agreements from 72 to 91% and kappa values from 0.43 to 0.64. Conclusion Data from HEMS operations can be gathered reliably in a national clinical quality registry. This study revealed some inaccuracies in data registration and data quality, which are important to detect to improve the overall reliability and validity of the HEMS clinical quality register.

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