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TABLE 1. Individual diagnosis of one referee and six independent observers using the original WHO goitre classification

Subject Individual rating
Referee Observer
1 2 3 4 5 6
1 1b 1b 1b 1b 1b 2 1b
2 2 2 2 2 2 2 2
3 0 1a 1b 1b 1a 2 1b
4 2 1b 1b 2 1a 1a 2
5 1b 1a 1b 1b 1b 1a 1b
6 1a 1a 0 1a 0 1a 0
7 1a 1a 1a 1b 1a 1a 1a
8 3 3 3 3 2 3 3
9 1b 1b 1b 1b 1b 1a 0
10 1a 1b 0 1a 0 0 0
11 2 2 1b 1a 1b 1b 1b
12 2 1b 1a 2 1b 1b 0
13 2 2 2 2 1b 1b 1b
1 1b 2 1b 0 1b 0 0
15 1b 1b 1b 1b 1b 1a 1b
16 0 1a 0 0 0 0 0
17 0 0 0 1a 0 1a 0
18 1b 2 3 2 1b 2 1b
19 0 1a 1b 1a 1a 1a 1b
20 3 3 3 3 1b 3 3
21 1b 1b 2 1b 1b 1a 1b
22 1b 2 2 2 1b 1a 1b
23 1b 3 1b 2 2 1a 1b
24 2 2 2 2 2 2 2
25 2 2 2 1b 1b 1a 1b

TABLE 2. Agreement across all categories of the WHO goitre classification for each pair of raters composed of one observer and his referee (paired kappa and standard error of kappa)

Referee Observer N Index of agreement Paired kappa (and SE)
Observed (p0) Expected (pe)
A 1 25 0.56 0.23 0.42 (0.10)
2 25 0.60 0.25 0.46 (0.11)
3 25 0.52 0.27 0.33 (0.10)
4 25 0.60 0.25 0.46 (0.10)
5 25 0.27 0.17 0.11 (0.08)
6 25 0.60 0.26 0.45 (0.10)
B 7 24 0.63 0.20 0.52 (0.10)
8 23 0.52 0.20 0.39 (0.10)
9 24 0.50 0.18 0.38 (0.09)
10 24 0.42 0.20 0.26 (0.09)
C 11 19 0.53 0.26 0.35 (0.12)
12 21 0.52 0.23 0.37 (0.11)
13 19 0.63 0.27 0.49 (0.12)
14 17 0.47 0.21 0.32 (0.11)
15 21 0.67 0.27 0.54 (0.11)
D 16 23 0.52 0.24 0.36 (0.10)
17 24 0.54 0.23 0.40 (0.10)
18 23 0.30 0.17 0.15 (0.08)

TABLE 3. Agreement on a single category—"no goitre"—for each pair of raters composed of one observer and his referee (paired kappa and standard error of the kappa)

Referee Observer N Index of agreement Paired kappa (and SE)
Observed (p0) Expected (pe)
A 1 25 0.88 0.81 0.37 (0.15)
2 25 0 84 0.79 0.25 (0.19)
3 25 0.84 0.73 0.40 (0.20)
4 25 0.84 0.73 0.40 (0.20)
5 25 0.80 0.76 0.17 (0.20)
6 25 0.72 0.65 0.20 (0.19)
B 7 24 0.79 0.64 0.42 (0.19)
8 23 0.87 0.64 0.64 (0.20)
9 24 0.75 0.66 0.27 (0.18)
10 24 0.88 0.64 0.65 (0.19)
C 11 19 0.79 0.51 0.57 (0.21)
12 21 0.67 0.53 0.29 (0.20)
13 19 0.95 0.50 0.89 (0.22)
14 17 0.76 0.56 0.47 (0.20)
15 21 0.81 0.51 0.61 (0.21)
D 16 23 0.96 0.81 0.78 (0.20)
17 24 0.92 0.78 0.62 (0.20)
18 23 0.91 0.71 0.70 (0.20)

The category of interest is no goitre" (stage 0); all other categories are combined into a single goitre" (stages 1a-3) category.

TABLE 4. Agreement a single category—"visible goitre"—for each pair of raters composed of one observer and his referee (paired kappa and standard error of the kappa)

Referee Observer N Index of agreement Paired kappa (and SE)
Observed (p0) Expected (pe)
A 1 25 0.76 0.52 0.50 (0.20)
2 25 0.80 0.53 0.58 (0.20)
3 25 0.72 0.60 0.31 (0.17)
4 25 0.76 0.54 0.48 (0.20)
5 25 0.68 0.56 0.27 (0.20)
6 25 0.84 0.58 0.62 (0.18)
B 7 24 1.00 0.51 1.00 (0.20)
8 23 0.83 0.52 0.64 (0.21)
9 24 0.83 0.54 0.64 (0.19)
10 24 0.75 0.54 0.45 (0.19)
C 11 19 0.79 0.66 0.38 (0.22)
12 21 0.76 0.61 0.39 (0.22)
13 19 0.79 0.71 0.27 (0.16)
14 17 0.82 0.61 0.55 (0.24)
15 21 0.90 0.59 0.77 (0.21)
D 16 23 0.74 0.47 0.51 (0.18)
17 24 0.67 0.49 0.35 (0.19)
18 23 0.61 0.44 0.30 (0.15)

The category of interest is "visible goitre (stages 2 and 3); all other categories are combined into a single no visible goitrc (stages 0 - 1b) category.

TABLE 5. Determination of averaged group kappa (SE = approximate standard error) among multiple observers on three different goitre categorizations

Goitre scalea Group N Index of a greement Averaged group kappa (and SE)
Observed (p0) Expected (pe)
I A 25 0.48 0.24 0.31 (0.13)
B 23 0.46 0.22 0.31 (0.13)
C 15 0.48 0.23 0.32 (0.16)
D 23 0.42 0.22 0.32 (0.13)
II A 25 0.86 0.76 0.41 (0.29)
B 23 0.83 0.72 0.37 (0.29)
C 15 0.77 0.57 0.46 (0.25)
D 23 0.93 0.71 0.75 (0.18)
III A 25 0.77 0.57 0.46 (0.20)
B 23 0.77 0.56 0.49 (0.20)
C 15 0.84 0.64 0.54 (0.27)
D 23 0.42 0.54 0.39 (0.20)

a. I = five stages WHO classification; II = presence/absence of goitre: III = presence/ absence of visible goitre.

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