Assessment of concordance between physicians, interns and students on COVID-19 severity using Fleiss Kappa

Authors

  • Daniela Abigail Cobo Álvarez
  • Carlos Escobar Suárez
  • Enrique Rodríguez Reyes

Keywords:

COVID-19, Fleiss' Kappa, inter-rater agreement, medical students, resident interns

Abstract

Introduction: The use of Fleiss' Kappa coefficient is applied in the evaluation of inter-rater concordance, which presents certain challenges within the medical practice setting.

Objective: The objective of this study was to evaluate the concordance between physicians, interns and medical students on the severity of patients with COVID-19 in a hospital in Ambato, Ecuador, using Fleiss' Kappa coefficient.

Methods: Inter-rater concordance was evaluated using Fleiss' Kappa statistical test. This was an analytical, observational, cross-sectional and prospective study. The study population consisted of two physicians, two interns and two final year medical students working in a hospital in Ambato, Ecuador.

Results: An overall Kappa value of 0.593 with an asymptotic standard error of 0.012, a Z value of 50.952, and a p-value of 0.000 were obtained. The asymptotic 95 % confidence intervals indicated that the Kappa value ranged from 0.571 to 0.616, which suggested that the overall agreement was in the moderate-considerable range. The results of Kappa coefficients for individual categories reflected different levels of agreement between raters.

Conclusions: Although a moderate-considerable level of overall agreement is observed among the evaluators, when analyzing individual categories, almost perfect agreement is evident for patients classified as Mild, but moderate and considerable levels of agreement for the Moderate and Severe categories, respectively.

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Published

2024-03-23

How to Cite

1.
Cobo Álvarez DA, Escobar Suárez C, Rodríguez Reyes E. Assessment of concordance between physicians, interns and students on COVID-19 severity using Fleiss Kappa. Rev Cubana Inv Bioméd [Internet]. 2024 Mar. 23 [cited 2025 Jul. 23];43. Available from: https://revibiomedica.sld.cu/index.php/ibi/article/view/3247