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.2-5
Perry JJ, Sivilotti MLA, Stiell IG. Subarachnoid Hemorrhage Diagnosis—Reply. JAMA. 2014;311(2):201–202. doi:10.1001/jama.2013.284327
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