Abstract
BackgroundAssessment of disagreement among multiple measurements for the same subject by different observers remains an important problem in medicine. Several measures have been applied to assess observer agreement. However, problems arise when comparing the degree of observer agreement among different methods, populations or circumstances.MethodsThe recently introduced information-based measure of disagreement (IBMD) is a useful tool for comparing the degree of observer disagreement. Since the proposed IBMD assesses disagreement between two observers only, we generalized this measure to include more than two observers.ResultsTwo examples (one with real data and the other with hypothetical data) were employed to illustrate the utility of the proposed measure in comparing the degree of disagreement.ConclusionThe IBMD allows comparison of the disagreement in non-negative ratio scales across different populations and the generalization presents a solution to evaluate data with different number of observers for different cases, an important issue in real situations.A website for online calculation of IBMD and respective 95% confidence interval was additionally developed. The website is widely available to mathematicians, epidemiologists and physicians to facilitate easy application of this statistical strategy to their own data.
Highlights
Assessment of disagreement among multiple measurements for the same subject by different observers remains an important problem in medicine
As several measurements in clinical practice and epidemiologic research are based on observations made by health professionals, assessment of the degree of disagreement among multiple measurements for the same subjects under similar circumstances by different observers remains a significant problem in medicine
The disagreement among judges was assessed as information-based measure of disagreement (IBMD) = 0.090 (95%confidence interval (CI) = [0.077;0.104]) considering the old rulebook and IBMD = 0.174 (95%CI = [0.154;0.192]) with new rulebook
Summary
Assessment of disagreement among multiple measurements for the same subject by different observers remains an important problem in medicine. Several measures have been applied to assess observer agreement. Problems arise when comparing the degree of observer agreement among different methods, populations or circumstances. As several measurements in clinical practice and epidemiologic research are based on observations made by health professionals, assessment of the degree of disagreement among multiple measurements for the same subjects under similar circumstances by different observers remains a significant problem in medicine. Same newborns under similar circumstances, followed by calculation of the measure of interobserver agreement, and the same procedure repeated with different nurses. Even when the appropriate form is applied to assess observer agreement, the ICC is strongly influenced by variations in the trait within the population in which it is assessed [6]. Important inconsistencies can be found when ICC is used to assess agreement [7]
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