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ABSTRACT: Objective
Although surgical-site infection (SSI) rates are advocated as a major evaluation criterion, the reproducibility of SSI diagnosis is unknown. We assessed agreement in diagnosing SSI among specialists involved in SSI surveillance in Europe.Methods
Twelve case-vignettes based on suspected SSI were submitted to 100 infection-control physicians (ICPs) and 86 surgeons in 10 European countries. Each participant scored eight randomly-assigned case-vignettes on a secure online relational database. The intra-class correlation coefficient (ICC) was used to assess agreement for SSI diagnosis on a 7-point Likert scale and the kappa coefficient to assess agreement for SSI depth on a three-point scale.Results
Intra-specialty agreement for SSI diagnosis ranged across countries and specialties from 0.00 (95%CI, 0.00-0.35) to 0.65 (0.45-0.82). Inter-specialty agreement varied from 0.04 (0.00-0.62) in to 0.55 (0.37-0.74) in Germany. For all countries pooled, intra-specialty agreement was poor for surgeons (0.24, 0.14-0.42) and good for ICPs (0.41, 0.28-0.61). Reading SSI definitions improved agreement among ICPs (0.57) but not surgeons (0.09). Intra-specialty agreement for SSI depth ranged across countries and specialties from 0.05 (0.00-0.10) to 0.50 (0.45-0.55) and was not improved by reading SSI definition.Conclusion
Among ICPs and surgeons evaluating case-vignettes of suspected SSI, considerable disagreement occurred regarding the diagnosis, with variations across specialties and countries.
SUBMITTER: Birgand G
PROVIDER: S-EPMC3706413 | biostudies-literature | 2013
REPOSITORIES: biostudies-literature
Birgand Gabriel G Lepelletier Didier D Baron Gabriel G Barrett Steve S Breier Ann-Christin AC Buke Cagri C Markovic-Denic Ljiljana L Gastmeier Petra P Kluytmans Jan J Lyytikainen Outi O Sheridan Elizabeth E Szilagyi Emese E Tacconelli Evelina E Troillet Nicolas N Ravaud Philippe P Lucet Jean-Christophe JC
PloS one 20130709 7
<h4>Objective</h4>Although surgical-site infection (SSI) rates are advocated as a major evaluation criterion, the reproducibility of SSI diagnosis is unknown. We assessed agreement in diagnosing SSI among specialists involved in SSI surveillance in Europe.<h4>Methods</h4>Twelve case-vignettes based on suspected SSI were submitted to 100 infection-control physicians (ICPs) and 86 surgeons in 10 European countries. Each participant scored eight randomly-assigned case-vignettes on a secure online r ...[more]