Helzer J E, Clayton P J, Pambakian R, Reich T, Woodruff R A, Reveley M A
Arch Gen Psychiatry. 1977 Feb;34(2):136-41. doi: 10.1001/archpsyc.1977.01770140026002.
In a study of interrater diagnostic reliability, 101 psychiatric inpatients were independently interviewed by physicians using a structured interview. Newly admitted patients were randomly selected and examined by one of three psychiatrists. A second psychiatrist reexamined the same patient about 24 hours later. Interviews from the two examinations were evaluated independently and diagnoses were made on the basis of objective criteria. The degree of diagnostic agreement for the two examinations were calculated using the kappa statistic. Agreement was found to be high as compared to other studies in the psychiatric literature, despite the fact that in most previous investigations diagnoses were not made independently. The results were also compared to studies of reliability of medical judgments. Possible reasons for the high interrater reliability are discussed and include the use of a structured interview and objective diagnostic criteria.
在一项关于评估者间诊断可靠性的研究中，101名精神科住院患者由医生使用结构化访谈进行独立访谈。新入院患者被随机挑选出来，由三位精神科医生中的一位进行检查。约24小时后，另一位精神科医生对同一名患者进行复查。对两次检查的访谈进行独立评估，并根据客观标准做出诊断。使用kappa统计量计算两次检查的诊断一致性程度。尽管在大多数先前的调查中诊断并非独立做出，但与精神科文献中的其他研究相比，发现一致性程度较高。研究结果还与医学判断可靠性的研究进行了比较。讨论了评估者间高可靠性的可能原因，包括使用结构化访谈和客观诊断标准。
