title: Intra-observer variability in APACHE II scoring.
abstract: Although the APACHE II score is the most widely used scoring system in intensive care units worldwide, its reliability and variability have not been extensively studied. Differences in case-mix may complicate comparison and interpretation of results. We hypothesised that a degree of variability might be inherent to use of the APACHE II scoring system, and decided to assess intra-observer variability in APACHE II scoring as a potential indicator of inherent score variability. APACHE II scores were assessed twice from the charts of 11 patients by 14 physicians, with a time interval of 4 (range 3.5-4.5) months between the two assessments. Intra-observer was found to be approximately 15%. These findings are in agreement with previous observations regarding inter-observer variability in APACHE II scoring, and strongly suggest that there is an inherent score variability of about 15%.
authors.affiliation: Department of Intensive Care, Vrije Universiteit Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands. k.polderman@tip.nl
authors.forename: K H
authors.initials: KH
authors.lastname: Polderman
authors.forename: H M
authors.initials: HM
authors.lastname: Christiaans
authors.forename: J P
authors.initials: JP
authors.lastname: Wester
authors.forename: J J
authors.initials: JJ
authors.lastname: Spijkstra
authors.forename: A R
authors.initials: AR
authors.lastname: Girbes
mesh_terms: D018806:APACHE; D000704:Analysis of Variance; D015986:Confounding Factors, Epidemiologic; D003422:Critical Care / Q000592:standards; D003953:Diagnosis-Related Groups / Q000145:classification / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D017408:Guidelines as Topic; D006801:Humans; D007318:Inservice Training; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards; D015588:Observer Variation; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index