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• 62 • Shanghai Archives of Psychiatry, 2015, Vol. 27, No. 1
•Biostatistics in psychiatry (25)•
Kappa coefficient: a popular measure of rater agreement
1 2 3 4 1,5
Wan TANG *, Jun HU , Hui ZHANG , Pan WU , Hua HE
Summary: In mental health and psychosocial studies it is often necessary to report on the between-rater
agreement of measures used in the study. This paper discusses the concept of agreement, highlighting
its fundamental difference from correlation. Several examples demonstrate how to compute the kappa
coefficient – a popular statistic for measuring agreement – both by hand and by using statistical software
packages such as SAS and SPSS. Real study data are used to illustrate how to use and interpret this coefficient
in clinical research and practice. The article concludes with a discussion of the limitations of the coefficient.
Keywords: interrater agreement; kappa coefficient; weighted kappa; correlation
[Shanghai Arch Psychiatry. 2015; 27(1): 62-67. doi: 10.11919/j.issn.1002-0829.215010]
1. Introduction coefficient for the two scores is 1, indicating perfect
For most physical illnesses such as high blood pressure correlation. The paradox occurs because there is a bias
and tuberculosis, definitive diagnoses can be made in the scoring that results in a consistent difference of
using medical devices such as a sphygmomanometer for 2 points in the scores of the two raters for all 6 items
blood pressure or an X-ray for tuberculosis. However, in the instrument. Thus, although perfectly correlated
there are
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