Inter-rater reliability of pressure ulcer staging: ordinal probit Bayesian hierarchical model that allows for uncertain rater response.
This article describes a method for estimating the inter-rater reliability of pressure ulcer (PU) staging (stages I-IV) from raters in National Database of Nursing Quality Indicators (NDNQI) participating hospitals. The method models ordinal spanning data utilizing an ordinal probit Bayesian hierarchical model (BHM) across several hospitals in which raters monitor patient's PUs. An ulcer that cannot be accurately assessed because the base of the wound cannot be seen is defined as unstageable. Our novel approach allows for an unstageable PU rating to be included in the analysis. We compare the ordinal probit BHM to an approximate random-effects (standard approach in the literature) model that assumes that the raw ordinal data are continuous.
Gajewski
Byron J
BJ
Schools of Allied Health and Nursing, Center for Biostatistics and Advanced Informatics, The University of Kansas Medical Center, Kansas City, KS 66160, U.S.A. bgajewski@kumc.edu
Hart
Sara
S
Bergquist-Beringer
Sandra
S
Dunton
Nancy
N
D001499:Bayes Theorem; D006801:Humans; D015233:Models, Statistical; D015588:Observer Variation; D003668:Pressure Ulcer / Q000175:diagnosis* / Q000473:pathology; D015203:Reproducibility of Results