Evidence map›Paper›PMID 41424984›Full record

Observational studyJournal of nursing management2025

Inter-rater Reliability of the Glasgow Coma Scale Between Triage and Resuscitation Nurses After Standardized Training.

Yangchun Zhang, Cairong Liu, Feng Chen, Na Ma, Yun Cao, Xufeng Chen, Xueli Ji

Abstract readObservational Study
In one paragraph

Observational study in Journal of nursing management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yangchun ZhangEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.ORCID 0000-0002-3489-6840
Cairong LiuEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.
Feng ChenEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.
Na MaEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.
Yun CaoEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.
Xufeng ChenEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.ORCID 0000-0003-3697-6446
Xueli JiEmergency Department, The First Affiliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, China, njmu.edu.cn.ORCID 0009-0007-6095-0672

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aims: To evaluate Glasgow Coma Scale (GCS) inter-rater reliability between triage and resuscitation nurses following standardized training and identify factors influencing scoring consistency in a high-volume Chinese trauma center. Design: A prospective observational study adhering to STROBE guidelines. Methods: Data were collected from 875 trauma patients and 71 nurses (30 triage and 41 resuscitation) between April and December 2024. Nurses completed a 19-h standardized GCS training program. Patients underwent two independent GCS assessments within ≤ 5 min: first by triage nurses and then by resuscitation nurses. Inter-rater reliability was assessed using percentage agreement, weighted Cohen's kappa, intraclass correlation coefficients (ICC), and correlation analyses. Multivariate logistic regression identified factors associated with scoring consistency. Results: GCS components and total scores demonstrated high inter-rater reliability (weighted kappa: 0.85-0.96; ICC: 0.85-0.96). Perfect agreement occurred in 65.3% of total GCS scores, with 89.8% differing by ≤ 1 point. Verbal response showed the highest component agreement (87.1%), followed by eye opening (86.5%) and motor response (75.1%). Patient characteristics significantly influenced consistency, with traumatic brain injury (adjusted OR = 0.22, Conclusion: Poststandardized training, GCS assessments showed high inter-rater reliability among emergency nurses, though motor response demonstrated comparatively lower consistency. Injury severity and traumatic brain injury were primary factors affecting scoring agreement, indicating the need for heightened vigilance when assessing critically ill patients. Relevance to Clinical Practice: Within China's developing prehospital triage infrastructure, standardized GCS training can substantially improve neurological assessment reliability in emergency settings, facilitating accurate identification of critically injured patients and optimizing resource allocation. Patient or Public Contribution: No patient or public contribution.

Indexed as

Glasgow Coma ScaleNursesResuscitationTeachingTriageAdultChinaFemaleHumansMaleMiddle AgedObserver VariationProspective StudiesReproducibility of Resultsemergency nursingGlasgow Coma Scaleinter-rater reliabilitystandardized assessmenttrauma triage

Identifiers

PMID41424984
PMCPMC12714156

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.