Understanding Interobserver Agreement: The Kappa Statistic

360 May 2005 Family MedicineIn reading medical literature on diagnosis and inter - pretation of diagnostic tests, our attention is generallyfocused on items such as sensitivity, specificity, pre-dictive values, and likelihood ratios. These items ad-dress the validity of the test. But if the people who ac-tually interpret the test cannot agree on the interpreta-tion, the test results will be of little us suppose that you are preparing to give a lec-ture on community-acquired pneumonia. As you pre-pare for the lecture, you read an article titled, Diag-nosing Pneumonia by History and Physical Examina-tion, published in the Journal of the American Medi-cal Association in You come across a table inthe article that shows agreement on physical examina-tion findings of the chest.

In reading medical literature on diagnosis and inter-pretation of diagnostic tests, our attention is generally focused on items such as sensitivity, specificity, pre-dictive values, and likelihood ratios. These items ad-dress the validity of the test. But if the people who ac-tually interpret the test cannot agree on the interpreta-

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  Statistics, Agreement, Inter, Kappa, I nterpretation, The kappa statistic, Pretation

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