Tobacman J K, Scott I U, Cyphert S T, Zimmerman M B
College of Medicine, University of Iowa, Iowa City, 52242-1081, USA.
Med Decis Making. 2001 Nov-Dec;21(6):490-7. doi: 10.1177/0272989X0102100607.
In this article, the authors determine the reproducibility of appropriateness ratings for cataract surgery between a multidisciplinary physician panel that convened and a multidisciplinary physician panel that completed ratings by mail.
Eighteen panelists, who constituted 2 distinct multidisciplinary panels, rated 2894 clinical scenarios as an appropriate, inappropriate, or uncertain indication to perform cataract surgery. Each panel's summary score for each scenario was calculated. Weighted kappa values were determined to assess the level of agreement between the ratings of the 2 panels.
The panels had a substantial level of agreement overall, with a weighted kappa statistic of 0.64. There was agreement on about 68% of the scenarios, and serious disagreement, in which one panel rated an indication appropriate and the other rated it inappropriate, occurred in only 1% of the ratings.
There was substantial agreement about the ratings by the 2 panels. The panel that convened rated fewer scenarios uncertain and more appropriate, suggesting the impact of group dynamics and face-to-face discussion on resolution of uncertainty.
在本文中，作者确定了召集的多学科医生小组与通过邮件完成评分的多学科医生小组之间白内障手术适宜性评分的可重复性。
18名小组成员组成了2个不同的多学科小组，他们将2894个临床病例评定为进行白内障手术的适宜、不适宜或不确定指征。计算了每个小组对每个病例的总结分数。通过加权kappa值来评估两个小组评分之间的一致程度。
两个小组总体上有较高的一致性，加权kappa统计值为0.64。在约68%的病例上存在一致性，而严重分歧（即一个小组将某个指征评定为适宜，另一个小组评定为不适宜）仅出现在1%的评分中。
两个小组的评分之间存在较高的一致性。召集的小组评定为不确定的病例较少，评定为适宜的病例较多，这表明群体动态和面对面讨论对不确定性的解决有影响。
