Table 3.

Level of agreement (kappa) and 95% confidence intervals between the NSP and cardiologist diagnosis after sequential performance of physical examination, ECG, FCU, and POC‐BNP

	Level of agreement with cardiologist
Diagnosis by NSP	Kappa	Pairwise difference
1. After physical examination	0.253
	(0.172‐0.340)
	P < .001
	n = 288
2. After physical examination and ECG	0.256	versus 1: P = .96
	(0.161‐0.345)
	P < .001
	n = 278
3. After physical examination, ECG, and FCU	0.468	versus 2: P = .002
	(0.376‐0.558)
	P < .001
	n = 289
4. After physical examination, ECG, FCU, and POC‐BNP	0.498	versus 3: P = .67
	(0.419‐0.580)
	P < .001
	n = 287

Pairwise P values indicate whether or not kappa was significantly different between each sequential diagnostic step.

Abbreviations: FCU, focused cardiac ultrasound; NSP, nonspecialist practitioner; POC‐BNP, point‐of‐care N‐terminal pro‐B‐type natriuretic peptide assay.