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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

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Minerva Pediatrica 2015 Sep 11


language: English

Inter and intra- rater reliability of nasal auscultation in daycare children?

Santos R. 1, Alexandrino A. S. 1, 2, Tomé D. 3, Melo C. 1, Montes A. M. 1, Costa D. 1, Ferreira J. P. 4

1 Physiotherapy Department, School of Allied Health Sciences of Porto (ESTSP) – Polytechnic Institute of Porto (IPP), Vila Nova de Gaia, Portugal; 2 Institute for Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal; 3 Audiology Department, School of Allied Health Sciences of Porto (ESTSP) – Polytechnic Institute of Porto (IPP), Vila Nova de Gaia, Portugal; 4 Otorhinolaryngology Department, Oporto Hospital Center, Edifício Neoclássico, Porto, Portugal


AIM: To assess nasal auscultation’s intra- and inter-rater reliability and to analyze ear and respiratory clinical condition according to nasal auscultation.
METHODS: Cross-sectional study performed in 125 children aged up to 3 years old attending daycare centres. Nasal auscultation, tympanometry and Paediatric Respiratory Severity Score (PRSS) were applied to all children. Nasal sounds were classified by an expert panel in order to determine nasal auscultation’s intra and inter- rater reliability. The classification of nasal sounds was assessed against tympanometric and PRSS values.
RESULTS: Nasal auscultation revealed substantial inter-rater (K =0.75) and intra-rater (K= 0.69; K= 0.61 and K= 0.72) reliability. Children with a “non-obstructed” classification revealed a lower peak pressure (t=-3,599, p<0,001 in left ear; t=-2,258, p=0,026 in right ear) and a higher compliance (t=- 2,728, p=0,007 in left ear; t=-3,830, p<0,001 in right ear) in both ears. There was an association between the classification of sounds and tympanogram types in both ears (X=11,437, p=0,003 in left ear; X=13,535, p=0,001 in right ear). Children with a “non-obstructed” classification had a healthier respiratory condition.
CONCLUSIONS: Nasal auscultation revealed substantial intra- and inter-rater reliability. Nasal auscultation exhibited important differences according to ear and respiratory clinical conditions. Nasal auscultation in pediatrics seems to be an original topic as well as a simple method that can be used to identify early signs of nasopharyngeal obstruction.

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