The influence of history on interobserver agreement for diagnosing actinic keratoses and malignant skin lesions.


Journal Article

BACKGROUND: Quantifying interobserver diagnostic agreement is necessary to evaluate skin cancer screening programs, but estimates of variability are incomplete. OBJECTIVE: We sought to measure agreement between dermatologists for diagnosing actinic keratoses (AKs) and malignant skin lesions and to determine the way in which blinding examiners to patient history affects agreement. METHODS: We varied the amount of historical information available to examiners in two consecutive patient series (n = 50) presenting to a Veterans Affairs Medical Center dermatology clinic. Two dermatologists examined each patient independently. RESULTS: Assessing historical features increased the kappa statistic for malignancy recognition from -0.04 to 0.76. kappa Statistics for diagnosing single AKs were 0.17 and 0.15, respectively, and 0.62 and 0.55 for multiple AKs. CONCLUSION: Agreement was high for diagnosing malignant skin lesions when history was included in the evaluation. Agreement for multiple AKs was higher than for single AKs, although neither was influenced by inclusion of historical features.

Full Text

Duke Authors

Cited Authors

  • Whited, JD; Horner, RD; Hall, RP; Simel, DL

Published Date

  • October 1995

Published In

Volume / Issue

  • 33 / 4

Start / End Page

  • 603 - 607

PubMed ID

  • 7673492

Pubmed Central ID

  • 7673492

International Standard Serial Number (ISSN)

  • 0190-9622

Digital Object Identifier (DOI)

  • 10.1016/0190-9622(95)91278-9


  • eng

Conference Location

  • United States