Background: Sputum production and purulence were proposed as criteria for justifying the use of antimicrobial agents. The Sputum Color Chart was developed and validated to standardize purulence of sputum evaluation. The aim of this study was to observe the reproducibility of the Sputum Color Chart from different categories of health caregivers.
Methods: The color of 10 sputum samples was evaluated using photographs for intra- and inter-reliability. The observation was repeated 3 times. Eighteen volunteers from 6 categories of health caregivers (student in physiotherapy, senior chest physiotherapist, junior resident in pulmonology, medical microbiologist, pulmonologist, and general practitioner) were investigated.
Results: Poor inter-rater reliability was observed for all categories with the exception of senior chest physiotherapists. The best intra-rater reliability was observed for microbiologists and senior chest physiotherapists. We found a great proportion (>40%) of important discrepancies in 2 categories (junior pulmonologist and general practitioner). The proportion of non-discrepancy between evaluators varied between 10 and 40%, depending on the category.
Conclusions: Even if the Sputum Color Chart is a useful tool for the clinician in the context of clinical deterioration, it presents non-uniform reliability regarding the caregivers and their category.
Keywords: COPD; evaluation; inter-rater; intra-rater; reproducibility; sputum.
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