van den Berg J P, Lankhorst G J
Rehabilitation Department, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Int Disabil Stud. 1990 Jan-Mar;12(1):20-1. doi: 10.3109/03790799009166597.
Since application of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) in its full form proved to be impractical, the use of selected parts, or of instruments based on the ICIDH, has been suggested. We have assessed the inter- and intra-rater reliability of disability ratings using a screening instrument, based on the D Code of the ICIDH. The level of functional abilities of all new patients (n = 39) seen by a resident at our outpatient clinic in an 11-week period was rated on a four-point scale for each of 28 items in five ability categories. Independent ratings were done by a resident and his supervisor (inter-rater reliability). Repeated rating by the resident was used to assess intra-rater reliability. Calculation of the inter- and intra-rater reliability was based both on the method of the relative agreement and on the measure kappa. The results showed relative agreements of greater than or equal to 82%, and kappa values of greater than or equal to 0.71 were found. This study shows that in a teaching hospital very satisfactory inter-rater and intra-rater reliabilities using a short instrument based on the D Code of the ICIDH can be achieved. It can therefore be recommended as a method for global disability rating.
由于事实证明全面应用《国际损伤、残疾和残障分类》（ICIDH）并不实际，因此有人建议使用其部分内容或基于ICIDH的工具。我们使用了一种基于ICIDH的D编码的筛查工具，评估了残疾评定的评分者间信度和评分者内信度。在11周的时间里，我们门诊一位住院医师接待的所有新患者（n = 39）的功能能力水平，按照五个能力类别中的28个项目，每个项目采用四点量表进行评分。由一位住院医师及其上级医师进行独立评分（评分者间信度）。住院医师的重复评分用于评估评分者内信度。评分者间信度和评分者内信度的计算基于相对一致性方法和kappa值测量。结果显示相对一致性大于或等于82%，kappa值大于或等于0.71。本研究表明，在一家教学医院，使用基于ICIDH的D编码的简短工具，可以实现非常令人满意的评分者间信度和评分者内信度。因此，它可以作为一种整体残疾评定方法被推荐。
