ArticlePloS one2023
Inter-rater reliability of the Silverman and Andersen index-a measure of respiratory distress in preterm infants.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03199898 (Reliability Testing of Silverman-Andersen Retraction Score in Preterm Infants), which is not on this map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Reliability Testing of Silverman-Andersen Retraction Score in Preterm Infants
Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Trial
- Article
- Spectral analysis of gastric aspirates obtained shortly after birth predicts the need for prolonged respiratory support in neonates in a development cohort.Frontiers in pediatrics · 2025Article
- Asymptotic Confidence Interval, Sample Size Formulas and Comparison Test for the Agreement Intra-Class Correlation Coefficient in Inter-Rater Reliability Studies.Statistics in medicine · 2024Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are various methods of respiratory support available to optimize respiratory function in preterm infants. Respiratory scoring tools might provide information on which method to choose and the level and duration of support needed. Before implementing a respiratory scoring tool in our clinical practice, we aimed to test the inter- and intra-rater reliability of the Silverman and Andersen index (SA index) among neonatologists and nurses when applied to preterm infants on respiratory support. We also examined the association between the SA index and the electrical activity of the diaphragm (Edi signals).
methodsThis was a multicenter study including three newborn intensive care units in Norway. Four neonatologists and 10 nurses applied the SA index when assessing 80 videos of 44 preterm infants on High Flow Nasal Cannula, Continuous Positive Airway Pressure and Neurally Adjusted Ventilatory Assist. The inter- and intra-rater reliability for the sum scores were measured by the intra-class correlation coefficient (ICC), and Kendall's W was used to assess the degree of agreement for each item. We quantified the association between the Edi signals and the SA index scores by the Spearman's correlation coefficient.
resultsWe found poor inter-rater reliability with an ICC for absolute agreement of 0.34 (95% CI: 0.20 to 0.53). There was fair agreement measuring each item separately for upper chest movements (Kendall's W 0.30), and moderate for lower chest movements (0.43) and xiphoid retractions (0.44). Expiratory grunting showed substantial agreement (0.67). The intra-rater reliability was good (ICC for absolute agreement 0.77; 95% CI: 0.68 to 0.84). We found a moderate positive correlation (r = 0.468, p = 0.028) between the maximum inspiratory diaphragm activity (Edi peak) and the mean inspiratory SA index scores.
conclusionOur study showed poor inter-rater and good intra-rater reliability of the SA index when nurses and neonatologists assessed videos of preterm infants on various types of respiratory support. Edi peak and SA index had a moderate positive correlation. Formal training might be essential to improve the inter-rater reliability.
trial registrationRegistered 26th June 2017, ClinicalTrials.gov Identifier: NCT03199898.
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