Premium
Global assessment of patients — a bedside study. II. Inter‐observer variation and frequency of clinical findings
Author(s) -
GJØRUP T.,
HENDRIKSEN C.,
BUGGE P. M.,
JENSEN A. M.
Publication year - 1990
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1990.tb00208.x
Subject(s) - medicine , variation (astronomy) , observer (physics) , intensive care medicine , astrophysics , quantum mechanics , physics
. Three physicians independently assessed 201 hospital in‐patients for the presence of 10 basic physical characteristics, and made an overall assessment of whether or not the patients appeared ill. There were significant differences between the physicians in the average number of observations recorded for each patient ( P < 0.001). There was a significant difference ( P < 0.05) between the physicians regarding the number of positive diagnoses of anaemia, abnormal nutritional state, breathing difficulties and the overall assessment. Inter‐observer variation was estimated by a pairwise comparison of the three physicians. Overall agreement rates ranged from 0.65 for abnormal nutritional state to 0.99 for presence of pain. After adjusting for random agreement, kappa values between 0.09 (elevated body temperature) and 0.88 (consciousness impaired) were found. No tendency towards a higher level of agreement in the overall assessment than in the basic findings was observed.