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Comment & Response
January 8, 2014

Subarachnoid Hemorrhage Diagnosis—Reply

Author Affiliations
  • 1Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
  • 2Department of Emergency Medicine, Queen’s University, Kingston, Ontario, Canada
JAMA. 2014;311(2):201-202. doi:10.1001/jama.2013.284327

In Reply Dr Specogna is concerned about selected elements of the OSHR showing only modest reliability. With κ values of 0.44, 0.49, and 0.55, and as high as 0.65 in the derivation study,1 these elements should not be deemed unreliable. κ Statistics represent a range from 1 (perfect agreement) to 0 (random chance). Even though excellent reliability is desired, κ values from 0.41 to 0.60 represent moderate agreement and can be used to construct a rule.25

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