TABLE 3.
Interrater Reliability for Physical Examination Findings
| Criterion | No. of Patients Evaluated | Characteristic Present per First Assessor, n/N (%) | Patient for Whom at Least 1 Assessor Marked “Unsure”, n | Missing Data, n | Overall Agreement, % | κ (95% CI)b | κ (95% CI) “Unsure” Responses Recodedc |
|---|---|---|---|---|---|---|---|
| Abdominal tendernessa (none, mild, moderate, severe) | 598 | N/A | 1 | 0 | 60.9 | .33 (.26–.40) | .33 (.26–.40) |
| Abdominal tendernessa (presence/absence) | 598 | 593 (99.0) | 1 | 0 | 98.7 | .49 (.19–.80) | .49 (.19–.80) |
| Right sided abdominal tenderness | 583 | 562 (93.8) | 15 | 1 | 91.1 | .30 (.16–.44) | .31 (.17–.44) |
| Maximal abdominal tenderness in RLQ | 554d | 447 (80.7) | 29 | 0 | 80.0 | .45 (.36–.54) | .42 (.33–.51) |
| Rebound | 548 | 224 (37.4) | 51 | 0 | 68.4 | .32 (.24–.40) | .30 (.22 -.38) |
| Guarding | 584 | 384 (64.1) | 14 | 1 | 67.5 | .30 (.23–.38) | .30 (.22–.37) |
| Abdominal pain with walking, jumping, or coughing | 494 | 418 (69.8) | 103 | 2 | 83.6 | .54 (.45–.63) | .44 (.35–.53) |
| Right-sided abdominal pain with walking, jumping, or coughing | 416e | 311 (74.8) | 76 | 2 | 77.6 | .52 (.43–.60) | .45 (.37–.53) |
a
Abdominal tenderness variable analyzed as ordinal data (none, mild, moderate, or severe tenderness) as originally collected and as a dichotomous variable (presence or absence of tenderness).
b
“Unsure” responses excluded from analysis.
c
“Unsure” responses recoded as the presence of particular finding.
d
Excludes patients in whom clinician marked “unsure” for right-sided abdominal pain.
e
Excludes those patients in whom clinician marked “unsure” for abdominal pain with walking, jumping, or coughing.