PT  - JOURNAL ARTICLE
AU  - Sigrun Losada Eskeland
AU  - Cathrine Brunborg
AU  - Birgitte Seip
AU  - Kristine Wiencke
AU  - Øistein Hovde
AU  - Tanja Owen
AU  - Erik Skogestad
AU  - Gert Huppertz-Hauss
AU  - Fred-Arne Halvorsen
AU  - Kjetil Garborg
AU  - Lars Aabakken
AU  - Thomas de Lange
TI  - First quality score for referral letters in gastroenterology—a validation study
AID  - 10.1136/bmjopen-2016-012835
DP  - 2016 Oct 01
TA  - BMJ Open
PG  - e012835
VI  - 6
IP  - 10
4099  - http://bmjopen.bmj.com/content/6/10/e012835.short
4100  - http://bmjopen.bmj.com/content/6/10/e012835.full
SO  - BMJ Open2016 Oct 01; 6
AB  - Objective To create and validate an objective and reliable score to assess referral quality in gastroenterology.Design An observational multicentre study.Setting and participants 25 gastroenterologists participated in selecting variables for a Thirty Point Score (TPS) for quality assessment of referrals to gastroenterology specialist healthcare for 9 common indications. From May to September 2014, 7 hospitals from the South-Eastern Norway Regional Health Authority participated in collecting and scoring 327 referrals to a gastroenterologist.Main outcome measure Correlation between the TPS and a visual analogue scale (VAS) for referral quality.Results The 327 referrals had an average TPS of 13.2 (range 1–25) and an average VAS of 4.7 (range 0.2–9.5). The reliability of the score was excellent, with an intra-rater intraclass correlation coefficient (ICC) of 0.87 and inter-rater ICC of 0.91. The overall correlation between the TPS and the VAS was moderate (r=0.42), and ranged from fair to substantial for the various indications. Mean agreement was good (ICC=0.47, 95% CI (0.34 to 0.57)), ranging from poor to good.Conclusions The TPS is reliable, objective and shows good agreement with the subjective VAS. The score may be a useful tool for assessing referral quality in gastroenterology, particularly important when evaluating the effect of interventions to improve referral quality.