TABLE 2

Interrater Reliability for Physical Examination Findings

CriterionNo. of Evaluable PatientsaNo. of Patients for Whom at Least 1 Assessor Marked “Unsure,” “Don't Know,” or “Unable to Assess”Characteristic Present per First Assessor, n/N (%)κ (95% CI)Percent Overall Agreement
General physical examination
    Concerning skin findings21703/217 (1.4)0.17 (−0.14 to 0.48)95.9
    Generally ill or not well appearing201421/201 (10.4)0.39 (0.20 to 0.58)87.1
Neurologic examinationb
    Abnormal mental status195925/195 (12.8)c0.48 (0.29 to 0.66)88.8
    Abnormal overall neurologic examination other than mental status19595/195 (2.6)0.40 (0.14 to 0.66)93.4
    Any focal neurologic findings (includes pupil size, cranial nerves motor tone, motor strength, and reflexes)20296/202 (3.0)0.66 (0.3 to 1.0)98.5
    Abnormal muscle tone20223/202 (1.5)0.59 (0.23 to 0.95)98.2
    Abnormal motor strength193124/193 (2.1)0.56 (0.12 to 1.0)98.4
    Abnormal sensation11786d1/117 (0.9)1.0 (1.0 to 1.0)100
    Abnormal reflexes164397/164 (4.3)0.48 (0.13 to 0.84)96.3
    Abnormal gait10797d2/107 (1.9)0.39 (−0.16 to 0.94)97.2
    Abnormal cranial nerves166311/166 (0.6)Unable to calculate99.4
    Abnormal cerebellar functione90340/90Unable to calculate97.8
    Unequal pupil size19911/199 (0.5)Unable to calculate99.5
    Abnormal posturing18532/185 (1.1)−0.007 (−0.017 to 0.003)98.4
    Abnormal speeche108191/108 (0.9)−0.009 (−0.02 to 0.004)98.1
  • a Excludes patients for whom data point from at least 1 assessor was missing or marked as “unsure,” “don't know,” or “unable to assess.”

  • b Excludes 6 patients who were sedated, paralyzed, or intubated at the time of examination.

  • c Truncated from the following: 170 (87.2%) normal mental status, 19 (9.7%) mildly impaired, and 6 (3.1%) moderately/severely impaired.

  • d Includes 64 patients (for sensation) and 66 (for gait) who were younger than 24 months.

  • e A priori excludes from all analyses patients either younger than 24 months or those sedated, paralyzed, or intubated at the time of examination (n = 85).