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Sample Size Requirements for Training to a [kappa] Agreement... » Isaúde
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Alzheimer Disease and Associated Disorders
2010-07-01 00:00:00

Sample Size Requirements for Training to a [kappa] Agreement Criterion on Clinical Dementia Ratings

Descrição: The Clinical Dementia Rating (CDR) is a valid and reliable global measure of dementia severity. Diagnosis and transition across stages hinge on its consistent administration. Reports of CDR ratings reliability have been based on 1 or 2 test cases at each severity level; agreement ([kappa]) statistics based on so few rated cases have large error, and confidence intervals are incorrect. Simulations varied the number of test cases, and their distribution across CDR stage; to derive the sample size yielding a 95% confidence that estimated is at least 0.60. We found that testing raters on 5 or more patients per CDR level (total N=25) will yield the desired confidence in estimated [kappa], and if the test involves greater representation of CDR stages that are harder to evaluate, at least 42 ratings are needed. Testing newly trained raters with at least 5 patients per CDR stage will provide valid estimation of rater consistency, given the point estimate for [kappa] is roughly 0.80; fewer test cases increases the standard error and unequal distribution of test cases across CDR stages will lower [kappa] and increase error. (C) 2010 Lippincott Williams & Wilkins, Inc.

Seção: Original Articles
Volume: 0
Autor: Tractenberg, Rochelle E.; Yumoto, Futoshi; Jin, Shelia; Morris, John C.


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