Observer accuracy and reproducibility of visual estimation of blood loss in obstetrics: how accurate and consistent are health-care professionals?

By:

Yoong, W

Contributor(s):

Publication details: 2010ISSN:

09320067

Uniform titles:

Archives of Gynecology & Obstetrics

Online resources:

Summary: <h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif; line-height: 17.999801635742188px;">OBJECTIVES:</h4>To evaluate the observer accuracy and intra-observer test-retest reliability of visual estimation of blood lossby midwives and obstetricians.<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;">METHODS:</h4>This was a prospective, single-blinded observational study conducted at a London teaching hospital. Theaccuracy of visually estimating five maternity pads that had been soaked with 25, 50, 100, 150 and 200 ml of blood was assessed. The reproducibility in estimating the same volume (two sets of pads soaked with 50, 100, 150 and 200 ml ofblood randomly placed at separate stations) was evaluated by asking participants to visually estimate these volumes.<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;">RESULTS:</h4>Although there is a tendency to overestimate, the mean percentage difference (estimated-actual volumes) was not significantly different among consultants, trainees and midwives. Visual estimations were especially inaccurate with smaller volumes, which could be overestimated by up to 540%. Test-retest reliability was poor for the larger volumes but statistically acceptable for the smaller volumes, although the difference between the two estimates of the same volume could be as much as 300%.<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;">CONCLUSIONS:</h4>Visual estimations were inaccurate by health-care professionals who have a tendency to overestimate. Experience did not appear to have a confounding effect on accuracy. Further training in visual assessment skills is necessary in order to improve the clinicians' estimation.

Holdings
Item type	Home library	Collection	Class number	Status	Date due	Barcode
UNKNOWN	Ferriman Information and Library Service (North Middlesex) Online	Staff publications for NMDX		Available

NMUH Staff Publications

281

<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif; line-height: 17.999801635742188px;">OBJECTIVES:</h4>To evaluate the&nbsp;observer&nbsp;accuracy&nbsp;and intra-observer&nbsp;test-retest reliability of&nbsp;visual&nbsp;estimation&nbsp;of&nbsp;blood lossby midwives and obstetricians.<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;">METHODS:</h4>This was a prospective, single-blinded observational study conducted at a London teaching hospital. Theaccuracy&nbsp;of visually estimating five maternity pads that had been soaked with 25, 50, 100, 150 and 200 ml of&nbsp;blood&nbsp;was assessed. The&nbsp;reproducibility&nbsp;in estimating the same volume (two sets of pads soaked with 50, 100, 150 and 200 ml ofblood&nbsp;randomly placed at separate stations) was evaluated by asking participants to visually estimate these volumes.<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;">RESULTS:</h4>Although there is a tendency to overestimate, the mean percentage difference (estimated-actual volumes) was not significantly different among consultants, trainees and midwives.&nbsp;Visual&nbsp;estimations were especially inaccurate with smaller volumes, which could be overestimated by up to 540%. Test-retest reliability was poor for the larger volumes but statistically acceptable for the smaller volumes, although the difference between the two estimates of the same volume could be as much as 300%.<h4 style="margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; line-height: 17.999801635742188px;">CONCLUSIONS:</h4>Visual&nbsp;estimations were inaccurate by health-care professionals who have a tendency to overestimate. Experience did not appear to have a confounding effect on&nbsp;accuracy. Further training in&nbsp;visual&nbsp;assessment skills is necessary in order to improve the clinicians'&nbsp;estimation.

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