Observer Disagreement in Physical Signs of the Respiratory System

Smyllie, H. C.; Blendis, Laurence M.; Armitage, P.

doi:10.1016/s0140-6736(65)90759-2

Cited by 89 publications

(49 citation statements)

References 5 publications

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“…Another five studies 24,25,29,56,57 reported more than 90% or "almost total" inter-examiner agreement for at least one PE sign.…”

Section: Resultsmentioning

confidence: 99%

“…The possibility that examiners differed in their PE skills is also suggested by the reported variability in the approach to the respiratory PE of 403 members of the British Thoracic Society 7 . A lack of adherence to appropriate PE technique also explains the low reliability found in studies of tachypnea 25,33 :…”

Section: Discussionmentioning

confidence: 99%

“…Values between 0 and 0.4 are commonly accepted as indicating low agreement, those between 0.4 and 0.6, fair agreement; between 0.6 and 0.8, good agreement; between 0.8 and 1, perfect agreement 64 . Less frequently, reliability was presented as agreement rates between examiners (e.g., 22 ), coefficients of correlation (e.g., 29 ) or the "standard deviation agreement index" (e.g., 25 ), which is, similar to the kappa statistics, a measure of inter-examiner agreement beyond the one expected by chance. "Validity" refers to the ability of a PE sign to discriminate between patients with and without the disease under consideration, and it is expressed as sensitivity and specificity relative to an agreed upon gold standard.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?

Benbassat

Baumal

2010

J GEN INTERN MED

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“…Another five studies 24,25,29,56,57 reported more than 90% or "almost total" inter-examiner agreement for at least one PE sign.…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?

Benbassat

Baumal

2010

J GEN INTERN MED

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“…[10][11][12][13][14] In view of these findings, however, some suggestions can be made in an attempt to remedy the situation. First, the development and widespread use of short courses in arteriography in which participants could be exposed to various examples of the pitfalls they are likely to encounter should be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Variability in the analysis of coronary arteriograms.

DeRouen¹,

Murray²,

Owen³

1977

Circulation

472

117

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provide views at 900 angles to one another. No hemiaxial views were taken. A stratified random sampling scheme was used to ensure selection of a representative spectrum of coronary disease groups, as categorized by the number of major vessels with at least 70% stenosis and by normal or abnormal left ventricular function. Only films estimated to be of adequate technical quality were eligible for this study. Eleven physicians, representing the Seattle Heart Watch cooperating facilities, individually reviewed these ten films in a pre-assigned random order and completed the standard Heart Watch arteriography forms. Three of the eleven subsequently met to resolve differences of opinion and provide a joint reading which could serve as a standard from an "expert panel."Raw observations collected were: the estimated amount of stenosis (percent narrowing in the diameters) of each of ten vessel segments, the presence or absence of collaterals, the degree of left ventricular contraction according to a qualitative five-division grading, as well as a film quality rating, and an overall assessment of the presence of coronary artery disease.The statistical approach taken for all entirely numerical variables was to use the standard deviation of the responses as a measure of the amount of variability and thus of the amount of agreement. When considering the amount of agreement on variables that were at least partially nominal in nature, standard deviations were not always applicable. For example, each reader was asked to estimate the amount of narrowing (to the nearest 10%) in the diameters of each of ten vessel segments from each patient. However, when the vessel segment was not sufficiently visible to allow an assess-324 CIRCULATION by guest on

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“…Schilling y cols 25 , encontraron 76% de concordancia en la pesquisa de ruidos respiratorios anormales en 187 pacientes con enfermedades pulmonares intersticiales y 88 sujetos control, con un valor de kappa de 0,25. Smyllie y cols, examinaron la habilidad clínica de 9 médicos que examinaron a 20 pacientes portadores de enfermedades respiratorias crónicas, encontrando grados moderados de concordancia en la pesquisa de matidez, disminución del murmullo pulmonar y crepitaciones 26 .…”

Section: Tabla 1 Diagnóstico Diferencial De La Neumonía Comunitaria unclassified

Valor predictivo de la historia clínica y el examen físico en el diagnóstico de la neumonía del adulto adquirida en la comunidad: Revisión de la literatura

R²,

2007

Rev. méd. Chile

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Observer Disagreement in Physical Signs of the Respiratory System

Cited by 89 publications

References 5 publications

Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?

Narrative Review: Should Teaching of the Respiratory Physical Examination Be Restricted Only to Signs with Proven Reliability and Validity?

Variability in the analysis of coronary arteriograms.

Valor predictivo de la historia clínica y el examen físico en el diagnóstico de la neumonía del adulto adquirida en la comunidad: Revisión de la literatura

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