Inter-rater reliability of the PIPES tool: validation of a surgical capacity index for use in resource-limited settings.INTRODUCTION
 In response to the need for simple, rapid means of quantifying surgical capacity in low resource settings, Surgeons OverSeas (SOS) developed the personnel, infrastructure, procedures, equipment and supplies (PIPES) tool.  The present investigation assessed the inter-rater reliability of the PIPES tool.


 As part of a government assessment of surgical services in Santa Cruz, Bolivia, the PIPES tool was translated into Spanish and applied in interviews with physicians at 31 public hospitals.  Correlation was 0.79 for the PIPES index, and ranged from 0.32 to 0.98 for continuous response items.


 Reliability of the PIPES tool was moderate for the infrastructure and procedures sections, fair for the equipment section, and poor for supplies section when comparing surgeons' responses to nurses' responses-an extremely rigorous test of reliability.  These results indicate that the PIPES tool is an effective measure of surgical capacity but that the equipment and supplies sections may need to be revised.
PIPES