This study describes the extent of agreement in classification of chest radiographs using the International Labor Organization (ILO) classification among six readers from the United States and Canada. A set of 119 radiographs was created and read by three Canadian and three US readers. The two ratings of interest were profusion (scored from 0/. to 3/+) and pleural abnormalities consistent with ...

AIM To compare two reference standards when evaluating a method of screening for referable diabetic retinopathy. METHOD Clinics at Oxford and Norwich Hospitals were used in a two centre prospective study of 239 people with diabetes receiving an ophthalmologist's examination using slit lamp biomicroscopy, seven field 35 mm stereophotography and two field mydriatic digital photography. Patients...

Early on, laparoscopic liver resection (LLR) was limited to partial resection, but major LLR is no longer rare. A difficulty scoring system is required to guide surgeons in advancing from simple to highly technical laparoscopic resections. Subjects were 90 patients who had undergone pure LLR at three medical institutions (30 patients/institution) from January 2011 to April 2014. Surgical diffic...

AIM The aim of the study was to evaluate the reliability of a panel of orthodontists for accepting new patient referrals based on clinical photographs. SAMPLE Eight orthodontists from Greater Manchester, Lancashire, Chester, and Derbyshire observed clinical photographs of 40 consecutive new patients attending the orthodontic department, Hope Hospital, Salford. METHOD They recorded whether o...

Evaluation of histological diagnosis requires an index of agreement (to measure repeatability and validity) together with a method of assessing bias. Cohen's kappa statistic appears to be the most suitable tool for measuring levels of agreement, which if unsatisfactory may be caused by bias. Further study of bias is possible by examining levels of agreement for each diagnostic category or by se...

BACKGROUND Patient evaluations are widely used in quality assessment of health services. It is widely recognized that patients and professionals provide a different perspective on quality. However, the extent to which they differ and the conceptual areas in which they differ is not well understood. OBJECTIVES We sought to examine how well professional and patient assessments of hospital healt...

Measuring agreement between qualified experts is commonly used to determine the effectiveness of a diagnostic procedure. Many methods are available for assessing agreement, including Cohen’s kappa, which is a very popular summary measure of agreement due to its appealingly simple usage and interpretation. However, it has been previously shown that a number of flaws exist in its usage, which can...