Paediatrics, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.
Social Paediatrics, Emma Children's Hospital, Amsterdam, The Netherlands.
BMJ Paediatr Open. 2022 Jul;6(1). doi: 10.1136/bmjpo-2022-001437.
To determine the intra-rater and inter-rater reliability of the Sexual Knowledge Picture Instrument (SKPI), a potential diagnostic instrument for young suspected victims of sexual abuse containing three scoring forms, that is, verbal responses, non-verbal reactions and red flags.
Video-recorded SKPI interviews with children with and without suspicion of child sexual abuse were observed and scored by two trained, independent raters. The second rater repeated the assessment 6 weeks after initial rating to evaluate for intra-rater reliability.
78 children aged 3-9 years old were included in the study. 39 of those included had known suspicion of sexual abuse and the other 39 had no suspicion.
Intra-rater and inter-rater reliability of the scores per study group and in the total sample were assessed by Cohen's kappa and percentage of agreement (POA).
The median intra-rater Cohen's kappa exceeded 0.90 and the POA exceeded 95 for all three forms in both study groups, except for the red flag form (median Cohen's kappa 0.54 and POA 87 in the suspected group, and 0.84 and 92, respectively, in the total sample). For the verbal scoring form the median inter-rater Cohen's kappa and POA were 1.00 and 100, respectively, in both groups. For the non-verbal form the median inter-rater kappa and POA were 0.37 and 97, respectively, in the suspected group, and 0.47 and 100, respectively, in the control group. For the red flag form, they were 0.37 and 76, respectively, in the suspected group and 0.42 and 77, respectively, in the control group.
The reliability of the SKPI verbal form was sufficient, but there is room for improvement in the non-verbal and red flag scoring forms. These forms may be improved by adjusting the manual and improving rater training.
确定性知识图片工具（SKPI）的评分者内信度和评分者间信度，该工具是一种潜在的性虐待年轻疑似受害者的诊断工具，包含三种评分形式，即言语反应、非言语反应和危险信号。
对有或无儿童性虐待嫌疑的儿童进行 SKPI 视频采访，并由两名经过培训的独立评分者进行评分。第二位评分者在初次评分 6 周后重复评估，以评估评分者内信度。
研究共纳入 78 名年龄 3-9 岁的儿童。其中 39 名儿童有已知的性虐待嫌疑，另外 39 名儿童没有嫌疑。
对每个研究组和总样本的评分进行评分者内信度和评分者间信度评估，采用 Cohen's kappa 和协议百分比（POA）。
在两个研究组中，除了危险信号评分形式（可疑组中位数 Cohen's kappa 为 0.54，POA 为 87，总样本中位数 Cohen's kappa 为 0.84，POA 为 92）外，所有三种形式的评分者内 Cohen's kappa 中位数均超过 0.90，POA 中位数均超过 95。言语评分形式的评分者间 Cohen's kappa 和 POA 中位数分别为 1.00 和 100，两组均如此。非言语形式的评分者间 kappa 和 POA 中位数分别为 0.37 和 97，可疑组如此，而对照组为 0.47 和 100。危险信号形式的评分者间 kappa 和 POA 中位数分别为 0.37 和 76，可疑组如此，而对照组为 0.42 和 77。
SKPI 言语形式的信度是足够的，但非言语和危险信号评分形式还有改进的空间。通过调整手册和改进评分者培训，可以改进这些形式。
