University of Oulu

Heino, A., Iirola, T., Raatiniemi, L. et al. The reliability and accuracy of operational system data in a nationwide helicopter emergency medical services mission database. BMC Emerg Med 19, 53 (2019).

The reliability and accuracy of operational system data in a nationwide helicopter emergency medical services mission database

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Author: Heino, A.1,2; Iirola, T.3; Raatiniemi, L.4;
Organizations: 1FinnHEMS Research and Development Unit, Vantaa, Finland
2Department of Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital and University of Turku, Turku, Finland
3Emergency Medical Services, Turku University Hospital and University of Turku, Turku, Finland
4Centre for Pre-Hospital Emergency Medicine, Oulu University Hospital, Oulu, Finland
5Emergency Medicine Services, Helsinki University Hospital and Department of Emergency Medicine, University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: Springer Nature, 2019
Publish Date: 2020-04-21


Aim: The aim of this study was to evaluate the reliability and accuracy of documentation in FinnHEMS database, which is a nationwide helicopter emergency service (HEMS) clinical quality registry.

Methods: This is a nationwide study based on written fictional clinical scenarios. Study subjects were HEMS physicians and paramedics, who filled in the clinical quality registry based on the clinical scenarios. The inter-rater -reliability of the collected data was analyzed with percent agreement and free-marginal multi-rater kappa.

Results: Dispatch coding had a percent agreement of 91% and free-marginal multi-rater kappa value of 0.83. Coding for transportation or mission cancellation resulted in an agreement of 84% and free-marginal kappa value of 0.68. An agreement of 82% and a kappa value of 0.73 for dispatcher coding was found. Mission end, arrival at hospital and HEMS unit dispatch -times had agreements from 80 to 85% and kappa values from 0.61 to 0.73. The emergency call to dispatch centre time had an agreement of 71% and kappa value of 0.56. The documentation of pain had an agreement of 73% on both the first and second measurements. All other vital parameters had less than 70% agreement and 0.40 kappa value in the first measurement. The documentation of secondary vital parameter measurements resulted in agreements from 72 to 91% and kappa values from 0.43 to 0.64.

Conclusion: Data from HEMS operations can be gathered reliably in a national clinical quality registry. This study revealed some inaccuracies in data registration and data quality, which are important to detect to improve the overall reliability and validity of the HEMS clinical quality register.

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Series: BMC emergency medicine
ISSN: 1471-227X
ISSN-E: 1471-227X
ISSN-L: 1471-227X
Volume: 19
Issue: 1
Article number: 53
DOI: 10.1186/s12873-019-0265-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: The FinnHEMS Research and Development Unit provided funding for AH for a three-month full-time scholarship between 2016 and 2018.
Copyright information: © The Author(s). 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.