INTEROBSERVER AGREEMENT ON DIAGNOSES MADE ACCORDING TO THE CISP - BASED ON ACTUAL CLINICAL SITUATIONS IN FAMILY MEDICINE

OBJECTIVE To measure interobserver agreement on diagnoses classified a nd coded by family physicians using manual or computerized input modes . METHOD Used increasingly in a variety of information management syst ems, the International Classification of Primary Care is the system be st adapted to primary care. Tell physicians independently viewed 44 ta ped medical visits. Five physicians were randomly assigned to manual c oding and five to computer coding. The study of reproducibility explor ed three aspects: written diagnoses, manually coded diagnoses, and dia gnoses coded using a software program. The ii statistic was calculated in order to compare interobserver agreement. RESULTS Descriptive anal ysis of interobserver agreement in the written diagnoses revealed an a greement rate of 70.5% (+/-6.3). Among physicians using manual coding, the agreement rate was 70.2% (+/-7.2). In the group using the softwar e program, the agreement rate was 75.0% (+/-8.7). The ii coefficients were low, but three were significant with critical ratios (z) above 1. 96. CONCLUSION Results suggest that input method has no bearing on int erobserver agreement and that agreement is more a function of clinical presentation of health problems than of coding process.