Shinar D, Gross C R, Mohr J P, Caplan L R, Price T R, Wolf P A, Hier D B, Kase C S, Fishman I G, Wolf C L
Arch Neurol. 1985 Jun;42(6):557-65. doi: 10.1001/archneur.1985.04060060059010.
Interobserver reliability in obtaining neurologic histories and examinations was investigated among neurologists collaborating in the Stroke Data Bank (SDB). Seventeen in-hospital stroke patients were examined by six neurologists experienced in stroke over the course of three days. Patients were examined twice a day for two successive days, with each patient seen by four different neurologists. Data were recorded on SDB forms, according to definitions and procedures established for the SDB. Percent agreement and kappa coefficients were calculated to assess the levels of agreement for each item. Important differences in levels of agreement were found among items on both neurologic history and examination. Agreement among neurologists was higher for neurologic examination than for history. Patterns of agreement for items with low prevalence or with numerous unknown ratings are discussed. Improvement in interobserver agreement due to data editing for intra-observer consistency was shown.
在参与卒中数据库（SDB）合作的神经科医生中，对获取神经病史和进行神经系统检查时的观察者间可靠性进行了调查。17例住院卒中患者在三天内由六位有卒中诊疗经验的神经科医生进行检查。患者连续两天每天接受两次检查，每位患者由四位不同的神经科医生检查。根据为SDB制定的定义和程序，将数据记录在SDB表格上。计算百分比一致性和kappa系数，以评估每个项目的一致性水平。在神经病史和检查项目中，发现一致性水平存在重要差异。神经科医生之间在神经系统检查方面的一致性高于病史方面。讨论了低患病率或有大量未知评级项目的一致性模式。结果显示，通过数据编辑以确保观察者内一致性，观察者间的一致性得到了改善。
