Toegepaste klinimetrie op de afdeling Intensive care

Summary

Applied clinimetrics in critical care
Saskia Rijkenberg

AIM: Measurements are the backbone of intensive care (ICU) medicine, as they are needed for diagnostic purposes, for continuous guidance of therapy and ultimately for prognostication.
This thesis aimed to assess the validity, reliability and accuracy of a number of clinical measurement instruments (pain assessment tools, continuous QTc measurement, continuous glucose measurement devices and a questionnaire concerning evidence based practice among nurses) which; I. are recommended by clinical guidelines, II. are part of the standard patient monitor but not yet commonly used in critical care, and III. have potential benefits in safety, efficacy and cost effectiveness.
METHOD: The Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) were used for the design, execution and analysis of most studies.
FINDINGS: The assessed measurement instruments have potential benefits for patient care, but the majority of the devices are still insufficiently developed to be fully utilized in clinical practice in a mixed ICU population.
CONCLUSION: This thesis assessed the psychometric properties of a number of measurements instruments that are used in ICU medicine and nursing. It is important to realize that measurement tools such as questionnaires need to be officially translated into and validated in the language in which the tool will be used. In addition, the psychometric properties of a measurement instrument must be assessed in the (patient) population in which it will be applied. This thesis is a contribution towards the process of assessing the psychometric properties of several measurement instruments. Therefore, additional research needs to be conducted to gain further insight into the validation of measurement instruments: clinimetric research is an ongoing process.

Keywords: Clinimetrics, intensive care, pain assessment, continuous glucose monitoring, QTc