Revicki D A
Med Care. 1984 Jul;22(7):661-9. doi: 10.1097/00005650-198407000-00008.
The dependability of medical billing diagnostic information was evaluated using a rating scale developed by Studney and Hakstian. Generalizability theory offers a comprehensive and flexible framework for analyzing problems associated with measures derived from multiple raters. The medical record and billing system diagnostic information from 45 patient encounters were rated according to similarity and value by three physician judges on two occasions. Data were analyzed using a three-way ANOVA design with levels of judges (3), occasions (2), and encounters (45). Examination of variance components and associated generalizability indicated that the judges and occasions factors or the interaction with occasions and other factors contributed little variance. The greatest proportion of variance was attributable to interindividual differences among the encounters and the interaction of judges and encounters. This investigation illustrates the application of a relatively new approach to practical measurement problems, generalizability theory.
使用由斯塔德尼和哈克斯蒂安开发的评分量表对医疗计费诊断信息的可靠性进行了评估。概化理论为分析与来自多个评分者的测量相关的问题提供了一个全面且灵活的框架。45次患者诊疗的病历和计费系统诊断信息由三位医生评委在两个时间点根据相似性和价值进行评分。使用具有评委水平（3）、时间点（2）和诊疗次数（45）的三因素方差分析设计对数据进行了分析。对方差成分和相关概化的检验表明，评委和时间点因素或时间点与其他因素的交互作用贡献的方差很小。最大比例的方差归因于诊疗之间的个体差异以及评委与诊疗之间的交互作用。本研究说明了一种相对较新的方法——概化理论在实际测量问题中的应用。
