Variability in expert assessments of child physical abuse likelihood
Variability in expert assessments of child physical abuse likelihood
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DOI：
10.1542/peds.2007-2485
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发表时间：
2008-04-01
期刊：
影响因子：
8
通讯作者：
Shapiro, Robert Allan
中科院分区：
文献类型：
--
作者：
Lindberg, Daniel Martin;Lindsell, Christopher John;Shapiro, Robert Allan
目标。在缺乏黄金标准的情况下，临床医生和研究人员经常使用几个序数表对他们对造成伤害的可能性的意见进行分类。该方案的目的是使用这些量表中的几个来确定专家评分的可靠性。方法：参与者是在评估有身体虐待问题的儿童方面有大量学术和临床活动的儿科医生。提交给1家医院虐待儿童小组的几个案件的事实被抽象并记录在一个多学科小组会议上。参与者观看了记录，并使用几种儿童虐待可能性量表对每个案例进行了评级。结果：参与者(n=22)在所有量表上对大多数案例显示出广泛的变异性。对于总体上对虐待的关注程度最高的案件，可变性最低。其中一个量表包括符合每个类别的病例实例和总结结果的标准报告语言，其中显示参与者的可变性略有下降(18%-23%)。对比额表使用的类别的解释更加一致。当可能性被估计为
OBJECTIVES. In the absence of a gold standard, clinicians and researchers often categorize their opinions of the likelihood of inflicted injury using several ordinal scales. The objective of this protocol was to determine the reliability of expert ratings using several of these scales.METHODS. Participants were pediatricians with substantial academic and clinical activity in the evaluation of children with concerns for physical abuse. The facts from several cases that were referred to 1 hospital's child abuse team were abstracted and recorded as in a multidisciplinary team conference. Participants viewed the recording and rated each case using several scales of child abuse likelihood.RESULTS. Participants (n = 22) showed broad variability for most cases on all scales. Variability was lowest for cases with the highest aggregate concern for abuse. One scale that included examples of cases fitting each category and standard reporting language to summarize results showed a modest (18%-23%) decrease in variability among participants. The interpretation of the categories used by the scales was more consistent. Cases were rarely rated as "definite abuse" when likelihood was estimated at