Feasibility and reliability of a newly developed antenatal risk score card in routine care. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: van Veen, Mieke J.; Birnie, Erwin; Poeran, Jashvant; Torij, Hanneke W.; Steegers, Eric A.P.; Bonsel, Gouke J.
• Is Part Of: Midwifery. Volume 31:Issue 1(2015)
• Page Start: 147
• Page End: 154
• Publication Date: 2015-01
• Subjects: Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2014.08.002
• Languages: English
• ISSNs: 0266-6138

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Objective</title> <p id="sp0030">to study in routine care the feasibility and inter-rater reliability of the Rotterdam Reproductive Risk Reduction risk score card (R4U), a new semi-quantitative score card for use during the antenatal booking visit. The R4U covers clinical and non-clinical psychosocial factors and identifies overall high risk pregnancies, qualifying for intensified antenatal care.</p> </sec> <sec> <title id="sect0015">Design</title> <p id="sp0035">a population-based cross-sectional study (feasibility) and a cohort study (inter-rater reliability).</p> </sec> <sec> <title id="sect0020">Setting</title> <p id="sp0040">feasibility was studied in six midwifery practices and two hospitals; the reliability study was performed in one midwifery practice.</p> </sec> <sec> <title id="sect0025">Participants</title> <p id="sp0045">1096 pregnant women in the feasibility study and a subsample of 133 participants in the inter-rater reliability study.</p> </sec> <sec> <title id="sect0030">Measurements</title> <p id="sp0050">feasibility was expressed as (a) time needed to complete the R4U and (b) the missing rate at the item and client level. For inter-rater reliability (IRR) an independent, blinded, caregiver completed a re-test R4U during a second visit; inter-rater agreement for each item and all domain sum scores were computed.</p> </sec> <sec> <title id="sect0035">Findings</title> <p id="sp0055">completion of the R4U took 5 minutes or less in 63%; and between 5 and 10 minutes in another 33%. On the participant level 0.2% of women had >20% missing values (below 4% threshold, <italic>P</italic><0.001). One of 77 items had a >10% missing rate. The per item IRR was 100% in 20% of the items, and below the predefined 80% threshold in 13% of the items (<italic>n</italic>=9). The domain sum scores universally differed less than the predetermined ±15% margin.</p> </sec> <sec> <title id="sect0040">Key conclusion</title> <p id="sp0060">the R4U risk score card is a feasible and reliable instrument.</p> </sec> <sec> <title id="sect0045">Implication for practice</title> <p id="sp0065">the R4U is suitable for the assessment of clinical and non-clinical risks during the antenatal booking visit in a heterogeneous urban setting in routine practice.</p> </sec> </abstract>