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Comment & Response |

Subarachnoid Hemorrhage Diagnosis—Reply

Jeffrey J. Perry, MD, MSc1; Marco L. A. Sivilotti, MD, MSc2; Ian G. Stiell, MD, MSc1
[+] Author Affiliations
1Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
2Department of Emergency Medicine, Queen’s University, Kingston, Ontario, Canada
JAMA. 2014;311(2):201-202. doi:10.1001/jama.2013.284327.
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In Reply Dr Specogna is concerned about selected elements of the OSHR showing only modest reliability. With κ values of 0.44, 0.49, and 0.55, and as high as 0.65 in the derivation study,1 these elements should not be deemed unreliable. κ Statistics represent a range from 1 (perfect agreement) to 0 (random chance). Even though excellent reliability is desired, κ values from 0.41 to 0.60 represent moderate agreement and can be used to construct a rule.25


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January 8, 2014
Adrian V. Specogna, MSc, PhD
1Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
JAMA. 2014;311(2):201. doi:10.1001/jama.2013.284318.
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