Lara M D, de la Fuente J R
División de Investigaciones Clínicas, Instituto Mexicano de Psiquiatría, México DF.
Acta Psiquiatr Psicol Am Lat. 1987 Sep;33(3):209-18.
Operational diagnostic criteria, structured interviews, and rating scales when appropriately used have improved the quality of clinical psychiatric research. The reliability of the Hamilton Anxiety Rating Scale scored on 5 previously diagnosed videotaped anxious patients is discussed. Patients were rated independently by 33 physicians from 13 countries. Results show higher agreement and concordance ratios on short and objective items. The opposite was true for lengthy and subjective items. The kappa (k) statistic while a popular measure of concordance defined as the fraction of agreement corrected for chance is shown to be of limited value in this study. Inasmuch as there is no gold standard, additional indexes are recommended to assess reliability of this and other similar psychiatric rating scales.
