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高一致性但低卡帕值:I. 两个悖论的问题。

High agreement but low kappa: I. The problems of two paradoxes.

作者信息

Feinstein A R, Cicchetti D V

机构信息

Yale University School of Medicine, New Haven, CT 06510.

出版信息

J Clin Epidemiol. 1990;43(6):543-9. doi: 10.1016/0895-4356(90)90158-l.

Abstract

In a fourfold table showing binary agreement of two observers, the observed proportion of agreement, p0, can be paradoxically altered by the chance-corrected ratio that creates kappa as an index of concordance. In one paradox, a high value of p0 can be drastically lowered by a substantial imbalance in the table's marginal totals either vertically or horizontally. In the second pardox, kappa will be higher with an asymmetrical rather than symmetrical imbalanced in marginal totals, and with imperfect rather than perfect symmetry in the imbalance. An adjustment that substitutes kappa max for kappa does not repair either problem, and seems to make the second one worse.

摘要

在展示两名观察者二元一致性的四格表中,观察到的一致性比例p0,可能会因作为一致性指标的kappa所基于的机遇校正比率而出现反常变化。在一个悖论中,若表格纵向或横向的边际总数存在显著失衡,p0的高值可能会大幅降低。在第二个悖论中,当边际总数存在不对称而非对称失衡时,以及失衡存在不完全而非完全对称时,kappa会更高。用kappa max替代kappa的调整并不能解决任何一个问题,而且似乎会使第二个问题变得更糟。

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