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Original article
Validation of the paediatric appropriateness evaluation protocol in British practice
  1. Ursula Wernekea,
  2. Helen Smithb,
  3. Iain J Smithc,
  4. Jeanette Taylord,
  5. Roderick MacFauld
  1. aLondon Health Economics Consortium, London School of Hygiene and Tropical Medicine, bWessex Primary Care Research Network, Southampton, cNuffield Institute for Health, Leeds, dRoyal College of Paediatrics and Child Health, London
  1. Dr R MacFaul, Health Services Committee, Royal College of Paediatrics and Child Health, 5 St Andrews Place, Regents Park, London NW1 4 LB.

Abstract

The reliability and validity of the North American paediatric appropriateness evaluation protocol (PAEP) for use in paediatric practice in Britain was tested. The protocol was applied to 418 case records of consecutive emergency admissions to three Yorkshire district general hospitals. The PAEP ratings were then compared with a clinical consensus opinion obtained from two expert panels. Altogether 32% of the admissions were rated inappropriate by the PAEP and 36% by the panels. Validity of the PAEP, as measured by agreement beyond chance with the expert panel rating, was only moderate with a κ of 0.29 (95% confidence interval 0.11 to 0.47). The PAEP has limited validity for evaluating British paediatric practice. Utilisation review instruments developed in differing clinical cultures should be used with caution until shown to be valid for the practice setting under review.

  • paediatric appropriateness evaluation protocol
  • hospitalisation
  • paediatric admissions

https://doi.org/10.1136/adc.77.4.294

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