Blanz B, Schmidt M H, Niemeyer J, Amorosa H
Department of Child Psychiatry, Central Institute for Mental Health, Mannheim, FRG.
Pharmacopsychiatry. 1990 Jun;23 Suppl 4:177-82. doi: 10.1055/s-2007-1014561.
In connection with the implementation of ICD-10, a further multicenter field study was conducted with 33 raters from 9 facilities for child and adolescent psychiatry. Each rater evaluated the same 29 case studies, resulting in a total of 957 ratings. When coding was done with 4-character ICD-10 codes interrater agreement on a given diagnosis averaged 50.3% (ICD-9: 47.3%); with 3-character ICD-10 codes the figure was 61.0% (ICD-9: 66.5%). When alternative diagnoses were also considered, agreement improved by about 7% (4-character codes) and 7.4% (3-digit codes), respectively. The highest levels of agreement were found for monosymptomatic disorders (F94, F95 and F98), the lowest for mixed disorders of conduct and emotions (F92) and depressive disorders (F31, F43). These results indicate that, on the whole, psychiatric disorders in children and adolescents can be classified reliably with the ICD-10, even when the raters have had no experience with the scheme.
在国际疾病分类第十版（ICD - 10）的实施过程中，针对来自9家儿童和青少年精神病学机构的33名评估人员开展了另一项多中心实地研究。每位评估人员对相同的29个案例进行评估，共计产生957个评分。使用4位数字的ICD - 10编码进行编码时，给定诊断的评估者间一致性平均为50.3%（ICD - 9为47.3%）；使用3位数字的ICD - 10编码时，该数字为61.0%（ICD - 9为66.5%）。当考虑替代诊断时，一致性分别提高了约7%（4位数字编码）和7.4%（3位数字编码）。单症状障碍（F94、F95和F98）的一致性水平最高，品行与情绪混合障碍（F92）和抑郁障碍（F31、F43）的一致性水平最低。这些结果表明，总体而言，即使评估人员没有该分类系统的经验，儿童和青少年的精神障碍也能够通过ICD - 10进行可靠分类。
