title: Reproducibility of the Sputum Color Evaluation Depends on the Category of Caregivers.
abstract: BACKGROUND
  Sputum production and purulence were proposed as criteria for justifying the use of antimicrobial agents. The Sputum Color Chart was developed and validated to standardize purulence of sputum evaluation. The aim of this study was to observe the reproducibility of the Sputum Color Chart from different categories of health caregivers.
  
  
  METHODS
  The color of 10 sputum samples was evaluated using photographs for intra- and inter-reliability. The observation was repeated 3 times. Eighteen volunteers from 6 categories of health caregivers (student in physiotherapy, senior chest physiotherapist, junior resident in pulmonology, medical microbiologist, pulmonologist, and general practitioner) were investigated.
  
  
  RESULTS
  Poor inter-rater reliability was observed for all categories with the exception of senior chest physiotherapists. The best intra-rater reliability was observed for microbiologists and senior chest physiotherapists. We found a great proportion (>40%) of important discrepancies in 2 categories (junior pulmonologist and general practitioner). The proportion of non-discrepancy between evaluators varied between 10 and 40%, depending on the category.
  
  
  CONCLUSIONS
  Even if the Sputum Color Chart is a useful tool for the clinician in the context of clinical deterioration, it presents non-uniform reliability regarding the caregivers and their category.
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL, and Dermatologie, Université Catholique de Louvain, Brussels, Belgium and the Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium. Institut Parnasse-ISEI, Brussels, Belgium. gregory.reychler@uclouvain.be.
authors.forename: Gregory
authors.initials: G
authors.lastname: Reychler
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Microbiologie, Université Catholique de Louvain, Brussels, Belgium and the Service de Microbiologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andre
authors.affiliation: Institut Parnasse-ISEI, Brussels, Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: Couturiaux
authors.affiliation: Department of Hygiene and Microbiology, Klinikum Wels-Grieskirchen, Wels, Austria.
authors.forename: Kinga
authors.initials: K
authors.lastname: Hohenwarter
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL, and Dermatologie, Université Catholique de Louvain, Brussels, Belgium and the Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liistro
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL, and Dermatologie, Université Catholique de Louvain, Brussels, Belgium and the Service de Pneumologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pieters
authors.affiliation: Institut de Recherche Expérimentale et Clinique (IREC), Pôle Epidémiologie et Biostatistique (EPID), Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Annie
authors.initials: A
authors.lastname: Robert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000592:standards*; D003116:Color; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012140:Respiratory Tract Diseases / Q000175:diagnosis*; D013183:Sputum; D063189:Symptom Assessment / Q000379:methods / Q000592:standards*; D055815:Young Adult
keywords: COPD; evaluation; inter-rater; intra-rater; reproducibility; sputum