RELIABILITY https://www.youtube.com/watch?v=KuT2n1w0Ixc
-
refers to how often multiple clinicians , examining the same patients ,
agree that a particular physical sign is
present or
absent
-
as characteristics of a
physical sign , reliability accuracy are distinct qualities , although significant inter-observer
d isagreement tends to undermine the finding's accuracy prevents clinicians from applying it confidently to their own
practice
-
disagreement about physical signs also contributes to the growing sense among clinicians (not necessarily justified) that
physical examination is less scientific than more technologic tests that physical examination lacks their diagnostic
authority
-
simple agreement (to express reliability/inter-observer agreement) >
-
the proportion of total observations in which clinicians
a)
gree about the finding
>
advantages= easy to calculate understand
-
>
disadvantage agreement may be quite high by
:
chance alone
-
what we want !
# -> valid/not reliable Be not valid/reliable + not valid/not reliable D+ valid/reliable
-
without reliability the best clinical
tests would be useless
X
XX
Y
* X
X ***
X XX
X
QUANTIFYING PRECISION : OBSERVER VARIATION
INTRA-OBSERVER AGREEMENT
-
does the same Clinician get the same result when applying the same test in the same patient ,
when the patient remains unchanged
INTER-OBSERVER AGREEMENT
-
do 2 or more clinicians obtain the same results when evaluating the same patient , using the same test for the same condition
KAPPA (k)
-
statistical measure that measures the agreement beyond chances Can be used to describe both the intras inter-observer agreements
KAPPA STATISTIC
>
-
values between 03 1
https://www.youtube.com/watch?v=DfNo32nL_fo
-valueof= observedagreement expected by
is the same as that an see
E G. . HYPOMOBILITY ?
A+
D
Pe(w y )N2(w2(a) Po Pe
+ -
Kappa K
,
Po
.
PHYS102 = = =
1 -
Pe
75
( , ) +30
. 75 -0 6
0
75 %
Po
Pe
.
-
+
= =
= I
T
10 G 1 -
0 . 6
-
Ao
Wi
+ observed 0 525 + 0 075
PHYSIC
78 agreement expected = . . = 0 375
.
agreement
- -
is 30
We = 0 6
.
N =
75 25
100
Y Yz
INTERPRETATION OF KAPPA VALLIE level of agreement between practitioners
POOR SLIGHT FAIR
MODERATE SUBSTANTIAL ALMOST PERFECT
-
&
KAppA 0 6
.
0 .
% I
-
refers to how often multiple clinicians , examining the same patients ,
agree that a particular physical sign is
present or
absent
-
as characteristics of a
physical sign , reliability accuracy are distinct qualities , although significant inter-observer
d isagreement tends to undermine the finding's accuracy prevents clinicians from applying it confidently to their own
practice
-
disagreement about physical signs also contributes to the growing sense among clinicians (not necessarily justified) that
physical examination is less scientific than more technologic tests that physical examination lacks their diagnostic
authority
-
simple agreement (to express reliability/inter-observer agreement) >
-
the proportion of total observations in which clinicians
a)
gree about the finding
>
advantages= easy to calculate understand
-
>
disadvantage agreement may be quite high by
:
chance alone
-
what we want !
# -> valid/not reliable Be not valid/reliable + not valid/not reliable D+ valid/reliable
-
without reliability the best clinical
tests would be useless
X
XX
Y
* X
X ***
X XX
X
QUANTIFYING PRECISION : OBSERVER VARIATION
INTRA-OBSERVER AGREEMENT
-
does the same Clinician get the same result when applying the same test in the same patient ,
when the patient remains unchanged
INTER-OBSERVER AGREEMENT
-
do 2 or more clinicians obtain the same results when evaluating the same patient , using the same test for the same condition
KAPPA (k)
-
statistical measure that measures the agreement beyond chances Can be used to describe both the intras inter-observer agreements
KAPPA STATISTIC
>
-
values between 03 1
https://www.youtube.com/watch?v=DfNo32nL_fo
-valueof= observedagreement expected by
is the same as that an see
E G. . HYPOMOBILITY ?
A+
D
Pe(w y )N2(w2(a) Po Pe
+ -
Kappa K
,
Po
.
PHYS102 = = =
1 -
Pe
75
( , ) +30
. 75 -0 6
0
75 %
Po
Pe
.
-
+
= =
= I
T
10 G 1 -
0 . 6
-
Ao
Wi
+ observed 0 525 + 0 075
PHYSIC
78 agreement expected = . . = 0 375
.
agreement
- -
is 30
We = 0 6
.
N =
75 25
100
Y Yz
INTERPRETATION OF KAPPA VALLIE level of agreement between practitioners
POOR SLIGHT FAIR
MODERATE SUBSTANTIAL ALMOST PERFECT
-
&
KAppA 0 6
.
0 .
% I
