Interobserver reliability of the modified-Goldman (m-Goldman) score
| Clinical feature | Proportion of patients with finding n (%) (physician n=912) | Proportion of patients with findingn (%) (nursing n=745) | Significance of difference (p value) | Kappa | 95% CI | Level of agreement (after Landis)18 |
|---|---|---|---|---|---|---|
| Typical new onset chest pain at rest | 394 (43.2) | 299 (40.1) | 0.21 | 0.22 | 0.15 to 0.30 | Fair |
| Pain the same as previous AMI | 115 (12.6) | 75 (10.1) | 0.11 | 0.53 | 0.43 to 0.63 | Moderate |
| Pain not relieved by glyceryl trinitrate spray within 15 min | 166 (18.2) | 133 (18.0) | 0.85 | 0.54 | 0.46 to 0.62 | Moderate |
| Pain lasting >60 min | 537 (58.9) | 472 (63.4) | 0.06 | 0.38 | 0.31 to 0.44 | Fair |
| Pain occurring with increasing frequency | 140 (15.4) | 146 (19.6) | 0.02 | 0.23 | 0.14 to 0.32 | Fair |
| Hypotension (systolic BP <100 mm Hg | 23 (2.5) | 16 (2.1) | 0.62 | 0.43 | 0.22 to 0.64 | Moderate |
| Acute shortness of breath | 167 (18.3) | 177 (23.8) | 0.007 | 0.26 | 0.18 to 0.34 | Fair |
| Pain within 6 weeks of AMI or revascularisation | 10 (1.1) | 8 (1.1) | 0.97 | 0.80 | 0.58 to 1.00 | Substantial |
| Low-risk patients (m-Goldman ≤1) | 426 (46.7) | 328 (44.0) | 0.28 | 0.31 | 0.24 to 0.38 | Fair |
AMI, acute myocardial infarction.