Cohen's kappa
Measures agreement between two raters or methods that assign categories to the same patients, beyond what chance alone would give.
Clinical example
Two radiologists independently classify the same chest X-rays as normal, abnormal or uncertain.
When to use it
- Two raters or methods assign categories to the same patients.
- You want agreement corrected for chance.
- The categories are ordered (use weighted kappa) or unordered (use unweighted kappa).
Assumptions to check
Same items rated by both raters
Every patient or image is rated by both raters, independently of each other.
What to report
- Kappa with 95% CI
- The cross-table of both raters
- The observed percentage of agreement
Common mistakes
Percent agreement isn't enough
Raters agree by chance some of the time. Report kappa, not only the percentage of agreement.
In your software
# R
library(irr)
kappa2(d[, c("rater_1", "rater_2")])
# Ordered categories: weighted kappa
# kappa2(d[, c("rater_1", "rater_2")], weight = "squared")
CROSSTABS
/TABLES=rater_1 BY rater_2
/STATISTICS=KAPPA
/CELLS=COUNT.
Sources
A confidence interval for kappa
The function kappa2() gives no confidence interval. A bootstrap confidence interval is one option: resample the patients (the pairs of ratings), recalculate kappa each time, and take the middle 95%.