Evidence map›Paper›PMID 38085328›Full record

ArticleEuropean archives of psychiatry and clinical neuroscience2024

Non-standard diagnostic assessment reliability in psychiatry: a study in a Brazilian outpatient setting using Kappa.

Helio G Rocha Neto, José Luiz Martins Lessa, Luisa Mendez Koiller, Amanda Machado Pereira, Bianca Marques de Souza Gomes, Carlos Linhares Veloso Filho, Carlos Henrique Casado Telleria, Maria T Cavalcanti, Diogo Telles-Correia

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Article in European archives of psychiatry and clinical neuroscience, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Helio G Rocha NetoPrograma de Pós-Graduação em Psiquiatria e Saúde Mental - PROPSAM, Instituto de Psiquiatria da UFRJ, Av.Venceslau Brás, nº71 Fundos, Gabinete da Direção, Botafogo, Rio de Janeiro, RJ, Brazil. helio.neto@edu.ulisboa.pt.ORCID http://orcid.org/0000-0002-7342-0634
José Luiz Martins LessaInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil.
Luisa Mendez KoillerInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil.
Amanda Machado PereiraInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil.
Bianca Marques de Souza GomesInstituto de Psiquiatria, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil.
Carlos Linhares Veloso FilhoPrograma de Pós-Graduação em Psiquiatria e Saúde Mental - PROPSAM, Instituto de Psiquiatria da UFRJ, Av.Venceslau Brás, nº71 Fundos, Gabinete da Direção, Botafogo, Rio de Janeiro, RJ, Brazil.
Carlos Henrique Casado TelleriaMedicine Faculty, Centro de Ciências da Saúde - CCS, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil.
Maria T Cavalcanti *Programa de Pós-Graduação em Psiquiatria e Saúde Mental - PROPSAM, Instituto de Psiquiatria da UFRJ, Av.Venceslau Brás, nº71 Fundos, Gabinete da Direção, Botafogo, Rio de Janeiro, RJ, Brazil.
Diogo Telles-Correia *Clinica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Universidade Federal do Rio de Janeiro · BRUniversity of Lisbon · PTFundação Instituto de Pesca do Estado do Rio de Janeiro · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The use of Structured Diagnostic Assessments (SDAs) is a solution for unreliability in psychiatry and the gold standard for diagnosis. However, except for studies between the 50 s and 70 s, reliability without the use of Non-SDAs (NSDA) is seldom tested, especially in non-Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We aim to measure reliability between examiners with NSDAs for psychiatric disorders. We compared diagnostic agreement after clinician change, in an outpatient academic setting. We used inter-rater Kappa measuring 8 diagnostic groups: Depression (DD: F32, F33), Anxiety Related Disorders (ARD: F40-F49, F50-F59), Personality Disorders (PD: F60-F69), Bipolar Disorder (BD: F30, F31, F34.0, F38.1), Organic Mental Disorders (Org: F00-F09), Neurodevelopment Disorders (ND: F70-F99) and Schizophrenia Spectrum Disorders (SSD: F20-F29). Cohen's Kappa measured agreement between groups, and Baphkar's test assessed if any diagnostic group have a higher tendency to change after a new diagnostic assessment. We analyzed 739 reevaluation pairs, from 99 subjects who attended IPUB's outpatient clinic. Overall inter-rater Kappa was moderate, and none of the groups had a different tendency to change. NSDA evaluation was moderately reliable, but the lack of some prevalent hypothesis inside the pairs raised concerns about NSDA sensitivity to some diagnoses. Diagnostic momentum bias (that is, a tendency to keep the last diagnosis observed) may have inflated the observed agreement. This research was approved by IPUB's ethical committee, registered under the CAAE33603220.1.0000.5263, and the UTN-U1111-1260-1212.

Indexed as

Mental DisordersOutpatientsAdultBrazilFemaleHumansMaleMiddle AgedPsychiatric Status Rating ScalesPsychiatryReproducibility of ResultsYoung AdultClinical decision-makingClinical reasoningDiagnoses and examinationsDifferential diagnosisMedical history-taking

Identifiers

PMID38085328
OpenAlexW4389616722

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.