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June 1985

Interobserver Variability in the Assessment of Neurologic History and Examination in the Stroke Data Bank

Author Affiliations

From the Ben Gurion University of the Negev, Beer-Sheva, Israel (Dr Shinar); Biometry and Field Studies Branch, NINCDS, National Institutes of Health, Bethesda, Md (Dr Gross and Mss Fishman, Wolf, and Kunitz); New York Neurological Institute, Columbia University, New York (Dr Mohr); Department of Neurology, Michael Reese Hospital and Medical Center, Chicago (Drs Caplan and Hier); Department of Neurology, University of Maryland Hospital and Medical Center, Baltimore (Dr Price); and Department of Neurology, Boston University Medical Center (Drs Wolf and Kase).

Arch Neurol. 1985;42(6):557-565. doi:10.1001/archneur.1985.04060060059010

• Interobserver reliability in obtaining neurologic histories and examinations was investigated among neurologists collaborating in the Stroke Data Bank (SDB). Seventeen in-hospital stroke patients were examined by six neurologists experienced in stroke over the course of three days. Patients were examined twice a day for two successive days, with each patient seen by four different neurologists. Data were recorded on SDB forms, according to definitions and procedures established for the SDB. Percent agreement and κ coefficients were calculated to assess the levels of agreement for each item. Important differences in levels of agreement were found among items on both neurologic history and examination. Agreement among neurologists was higher for neurologic examination than for history. Patterns of agreement for items with low prevalence or with numerous unknown ratings are discussed. Improvement in interobserver agreement due to data editing for intra-observer consistency was shown.