Table 2.
Accuracy of CBSV assessments compared to their supervisors (the District-based project supervisors (DiPS) during directly observed supervisory (DOS) visits (N = 759)
| Danger sign | Danger sign present (based on DiPS assessment)a | Agreement (%) | Kappa (95% CI)b | Sensitivity (95% CI) | Specificity (95% CI) |
|---|---|---|---|---|---|
| Observed sign | |||||
| Chest in-drawing | 22 (2.9%) | 99.3 | 0.85 (0.71, 1.00) | 59.1% (36.4%, 79.3%) | 99.9% (99.3%, 100.0%) |
| Only moves when stimulated | 7 (0.9%) | 100.0 | 1.00 (1.00, 1.00) | 57.1% (18.4%, 90.1%) | 100.0% (99.5%, 100.0%) |
| Yellow soles | 14 (1.8%) | 99.6 | 0.84 (0.66, 1.00) | 57.1% (28.9%, 82.3%) | 100.0% (99.5%, 100.0%) |
| Local infections (Eye/skin/cord) | 61 (8.0%) | 99.6 | 0.97 (0.94, 1.00) | 95.1% (86.3%, 99.0%) | 100.0% (99.5%, 100.0%) |
| Measured with instrument | |||||
| Respiratory rate (first count) 60+/minutes | 93 (12.3%) | 94.9 | 0.75 (0.67, 0.83) | 73.1% (62.9%, 81.8%) | 97.5% (95.9%, 98.5%) |
| Respiratory rate (second count) 60+/minutes | 57 (7.5%) | 91.6 | 0.83 (0.69, 0.96) | 92.7% (80.1%, 98.5%) | 91.2% (76.3%, 98.1%) |
| Hypothermia: temperature <35.5°C) | 10 (1.3%) | 99.9 | 0.94 (0.82, 1.00) | 80.0% (44.4%, 97.5%) | 99.9% (99.3%, 100.0%) |
| Fever: temperature >37.4°C | 23(3.0%) | 99.3 | 0.90 (0.81, 0.99) | 100.0% (85.2%, 100.0%) | 99.3% (98.4%, 99.8%) |
| vLBW (<1.5 kg) | 1 (0.1%) | 100.0 | 1.00 (1.00, 1.00) | 100.0% (2.5%, 100.0%) | 100.0% (99.5%, 100.0%) |
| REFERRED | 127 (16.7%) | 96.6 | 0.87 (0.82, 0.92) | 79.5% (71.5%, 86.2%) | 100.0% (99.4%, 100.0%) |
aThe column labelled ‘danger sign present based on DiPS assessment’ represents the proportion of the newborns assessed who had a particular danger sign.
bKappa is the statistical coefficient of agreement between the DiPS and the volunteer. A high Kappa means high agreement and conversely a low Kappa means poor agreement; P < 0.001 for all the Kappa statistics.