Appropriate Statistics for Determining Chance-Removed Interpractitioner Agreement

The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy
Michael PopplewellChris Zaslawski

Abstract

Objectives: Fleiss' Kappa (FK) has been commonly, but incorrectly, employed as the "standard" for evaluating chance-removed inter-rater agreement with ordinal data. This practice may lead to misleading conclusions in inter-rater agreement research. An example is presented that demonstrates the conditions where FK produces inappropriate results, compared with Gwet's AC2, which is proposed as a more appropriate statistic. A novel format for recording a Chinese Medical (CM) diagnoses, called the Diagnostic System of Oriental Medicine (DSOM), was used to record and compare patient diagnostic data, which, unlike the contemporary CM diagnostic format, allows agreement by chance to be considered when evaluating patient data obtained with unrestricted diagnostic options available to diagnosticians. Design: Five CM practitioners diagnosed 42 subjects drawn from an open population. Subjects' diagnoses were recorded using the DSOM format. All the available data were initially used to evaluate agreement. Then, the subjects were sorted into three groups to demonstrate the effects of differing data marginality on the calculated chance-removed agreement. Outcome measures: Agreement between the practitioners for each subject was evaluated...Continue Reading

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Citations

Nov 2, 2018·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Michael PopplewellChris Zaslawski
Mar 14, 2020·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Tetsuhiro Yoshino, Kenji Watanabe
Nov 16, 2019·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Lisa Taylor-SwansonLisa Conboy
Nov 16, 2019·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Stephen Birch
Apr 17, 2021·The Journal of Alternative and Complementary Medicine : Research on Paradigm, Practice, and Policy·Ayako Maeda-MinamiKenji Watanabe

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