First 254 words of the document:
Reliability of diagnosis
Reliable diagnosis = if two clinicians use the same diagnostic system (e.g. the DSM) to
diagnose the same patient and come to the same diagnosis then the diagnosis is said to
Inter-rater reliability = when different clinicians agree on the same diagnosis for the same
Test-retest reliability = to assess the same patients two or more times and see whether
they consistently receive the same diagnosis.
The reliability of real-life diagnosis
Pontizovsky et al (2006)
· Looked at the agreement between diagnosis on admission and on release for 998
patients admitted to Israeli psychiatric hospitals in 2003 suffering from depression and
related mood disorders, and 1013 with schizophrenia and related psychotic disorders.
· 94.2% of patients had the same diagnosis when released from hospital as when
· Kappa figure = 0.68
· PPV for psychotic = 83.8%
· Reasonably good reliability for ICD diagnosis.
Nicholls et al (2000)
· 81 patients aged 7 - 16 years with an eating disorder were classified using ICD-10,
DSM-IV and the and the system used by Great Ormond Street Hospital.
(The Great Ormond Street system was designed exactly for diagnosing children)
· Over 50% of children could not be diagnosed by the DSM criterion.
· Reliability was 0.64 (64% agreement between raters) - most could not diagnose.
· ICD-10 = 0.36 reliability (36% agreement between raters)
· Great Ormond Street system = reliability of 0.88 (88% agreement between raters)
· Neither ICD-10 or DSM-IV demonstrates good inter-rater reliability for the diagnosis of
eating-disorders in children.