Table 1.

Inter-rater reliability scores for final safety-netting tool^a

Code	Variables	Agreement, % (weighted)	κ (ICC)
Safety-netting contextual codes
Diagnostic uncertainty	No, yes, n/a	80	0.62
Expected time course of illness	No, yes, n/a	83	0.66
Follow-up	None, investigation only, practice, same GP, other, multiple	74 (83)b	0.77b
Follow-up documentationc	No, yes, CBD, n/a	100	1
Safety-netting advice codes
Applicable to problem, treatment or management plan, or both	Problem, treatment or management plan, both	88 (92)d	0.75d
Stage of the consultation	Establishing reason, gathering information, delivering diagnosis, treatment planning, closing, unclear	82	0.67
Initiation	Clinician, patient	96	0
Format	Conditional plus course of action, conditional warning onlye	98	0.79
Strength of endorsement	Weaker, neutral, stronger	94	0.87
Conditions/symptoms, n	1–20	84 (99) f	0.85f (0.86)
Generic or specific advice	Generic, specific	80	0.61
Action advisedg	None (conditional only), other in-hours, practice, same HCP, OOH, 999	88	0.78
Timescale of actiong	Not specified, fixed, immediate	92	0.80
Focus of action	No action, clinician focused, patient focused, both	84 (89)h	0.79h
Patient response	No response, resists, nods only, acknowledgement or accepts	80	0.55
Patient questions	No, yes	97	0.65
Written information	Verbal only, verbal and written, unclear	94	0
Documentationc	No, yes, CBD	85	0.71
Total mean average		88 (90)	0.66

^aA total of 51 discrete episodes of safety-netting advice for 35 problems in 24 consultations were recorded.

^bWeight: 0.5 (half correct) if multiple matched to any other code other than none.

^cInter-rater reliability not assessed when n/a as no follow-up or safety-netting advice, or when no medical records available.

^dWeight: 0.5 when both matched with either problem or treatment.

^eOne variable dropped, limited prognostic statement only.

^fQuadratic weighting.

^gFrom a repeated cycle of coding tool analysis based on 25 episodes of safety-netting advice across 13 problems from 10 consultations.

^hWeight: 0.5 when both matched with either clinician- or patient-focused action. CBD = cannot be determined. HCP = healthcare professional. ICC = intra-class correlation coefficient. n/a = not applicable. OOH = out of hours.