INTERRATER RELIABILITY OF A PEDIATRIC OUTCOME MEASURE IN NEPAL

The Hospital and Rehabilitation Centre for Disabled Children (HRDC) in Nepal identified the need to evaluate their in-hospital and community programmes. An instrument was developed to provide information regard ing the functional level of the children treated by the HRDC as well a s to provide information regarding care-givers' attitudes towards disa bility. Inter-rater reliability of the measure was tested in three reg ions of Nepal with 49 children. Six HRDC field workers travelled in pa irs to the childrens' homes and alternated in roles as test administra tor and observer. Correlations between the scores documented by the ad ministrator and observer were used to estimate inter-rater reliability . Inter-rater reliability coefficients, calculated using a weighted ka ppa statistic, varied from 0.60 to 1.0. We conclude that the instrumen t demonstrated an acceptable level of inter-rater reliability in the f ield setting. Future studies to measure construct and concurrent valid ity, test-retest reliability and responsiveness of the instrument are recommended as well as testing the instrument in different cultures.