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【medical-news】Apgar评分结果取决于打分者
Wed Nov 1, 2006 4:02pm ET
By David Douglas
NEW YORK (Reuters Health) - The 5-minute Apgar score assigned to infants immediately after delivery varies considerably among different observers, Australian investigators concluded after viewing the video recordings of newborn resuscitations.
"The implication of this study," lead researcher Dr. Colm P. F. O'Donnell told Reuters Health, "is that we need more objective measures of infant well-being in the minutes after birth" to judge the effectiveness of resuscitation efforts in both clinical practice and trials.
The Apgar score, which was developed by anesthesiologist Dr. Virginia Apgar in 1953, rates a newborn infant's respiration, heart rate, muscle tone, reflexes and skin color, O'Donnell of Royal Women's Hospital Melbourne and colleagues note. All measures, other than heart rate, are based on visual inspection. The maximum score is 10.
To examine variability in the scores, the researchers showed 10-second clips of 30 newborns taken at 5 minutes of age to 42 observers, consisting of neonatal, obstetric medical, and nursing staff. The observers then scored the infants themselves.
The scores showed large variability in all four subjective elements, regardless of the infant's level of illness, the investigators report in the Journal of Pediatrics.
The average score given by those who had actually attended the delivery was 2.4 points higher than that of the video observers. There was no evidence that a particular staff group was substantially associated with the level of discrepancy.
In an accompanying editorial, Dr. William Keenan of Saint Louis University, Missouri calls the data "appalling" but notes that they "are consistent with previous findings."
For the Apgar score to remain of value, it will need to be more reliable; the sources of variation must be identified; performance expectations should be calified, better training is needed and investment in quality control must be made, he concludes.
SOURCE: Journal of Pediatrics, October 2006.
http://today.reuters.com/news/articlenews.aspx?type=healthNews&storyID=2006-11-01T210229Z_01_COL174380_RTRUKOC_0_US-APGAR-TEST.xml 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 【medical-news】Apgar评分结果取决于打分者
NEW YORK (Reuters Health) - The 5-minute Apgar score assigned to infants immediately after delivery varies considerably among different observers, Australian investigators concluded after viewing the video recordings of newborn resuscitations. 路透社健康新闻纽约讯—在检视新生儿复苏的录象带之后，澳大利亚调查人作出结论：对于不同观测者，新生儿出生5分钟的Apgar评分相差很大。
"The implication of this study," lead researcher Dr. Colm P. F. O'Donnell told Reuters Health, "is that we need more objective measures of infant well-being in the minutes after birth" to judge the effectiveness of resuscitation efforts in both clinical practice and trials.首席研究员Colm P. F. O'Donnell博士对路透社健康新闻记者说：“这项研究提示我们需要建立更客观的方法，以评价产后数分钟内的新生儿状态，以便在临床实践和试验中能鉴定复苏措施的有效性。”
The Apgar score, which was developed by anesthesiologist Dr. Virginia Apgar in 1953, rates a newborn infant's respiration, heart rate, muscle tone, reflexes and skin color, O'Donnell of Royal Women's Hospital Melbourne and colleagues note. All measures, other than heart rate, are based on visual inspection. The maximum score is 10. Apgar评分是在1953年由麻醉学专家Virginia Apgar博士提出，它评估新生儿的呼吸、心率、肌张力、反射应激性和肤色；墨尔本皇家女子医院的O'Donnell和同事们记录到：除心率外，所有的检查方法都基于视觉检查。（Apgar评分）总分10分。
To examine variability in the scores, the researchers showed 10-second clips of 30 newborns taken at 5 minutes of age to 42 observers, consisting of neonatal, obstetric medical, and nursing staff. 为了调查评分存在易变性，研究人员向42名观察者（包括新生儿科医生、产科医生和护理人员）放映了30个出生5分钟新生儿的10秒钟录象剪辑。The observers then scored the infants themselves.然后观察者对新生儿评分。
The scores showed large variability in all four subjective elements, regardless of the infant's level of illness, the investigators report in the Journal of Pediatrics.排除婴儿疾病的因素，评分在四个主观检查项上存在很大变异性，该研究发表于小儿科杂志。
The average score given by those who had actually attended the delivery was 2.4 points higher than that of the video observers. 在产房接生的人打的分数比看录象的高出2.4分。There was no evidence that a particular staff group was substantially associated with the level of discrepancy. 还没有证据显示特定的医疗群体与评分差异水平存在必然关联。
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作者:admin@医学,生命科学 2010-11-08 05:11
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