Document Detail

Inter-rater evaluation of a clinical scoring system in children with asthma.
MedLine Citation:
PMID:  11868927     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Many clinical scores that measure the degree of asthma are used without adequate evaluation of inter-rater reliability. When reliability is tested, most often the Cohen K statistic is used, which limits the comparative results of only two raters at a time. OBJECTIVE: To evaluate inter-rater agreement of a clinical asthma score using a multi-rater K statistic. METHODS: Four raters administered a clinical asthma score to 17 children with clinical asthma. Five items were evaluated: O2 requirement, inspiratory breath sounds, accessory muscle use, expiratory wheeze, and cerebral function. For each, a score of zero indicated a normal state; one, moderate impairment; two, severe impairment. A multi-rater kappa statistic was used as a measure of agreement among all four raters simultaneously. This was applied using hand calculations then cross-checked by using a standard statistical syntax, a component of the Statistical Package for Social Sciences (SPSS 9.0). RESULTS: Application of the multi-rater K statistic revealed strong agreement among raters on oxygenation (K = 0.759), moderate agreement for expiratory wheeze and cerebral function (K = 0.698), and poor agreement for accessory muscle use (K = 0.528) and inspiratory breath sounds (K = 0.316). CONCLUSIONS: The level of agreement varied by item with the least subjective item, O2 requirement, demonstrating the highest inter-rater correlation. A multi-rater kappa statistic can be applied to data obtained from a clinical scoring instrument either manually or by using statistical syntax provided by SPSS.
Mary Lu Angelilli; Ronald Thomas
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology     Volume:  88     ISSN:  1081-1206     ISO Abbreviation:  Ann. Allergy Asthma Immunol.     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-28     Completed Date:  2002-03-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9503580     Medline TA:  Ann Allergy Asthma Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  209-14     Citation Subset:  IM    
Wayne State University School of Medicine, Pediatrics, Detroit, Michigan, USA.
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MeSH Terms
Asthma / diagnosis*,  physiopathology
Observer Variation
Reproducibility of Results
Severity of Illness Index*
Statistics as Topic / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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