title: Development of diagnostic reference frames for seizures. Part 1: inter-participant agreement in the selection of symptoms.
abstract: OBJECTIVE
  Our aim is to develop reliable descriptions of various seizure types, which will be used as a basis for decision support. We use expert opinions in this process. In this contribution we evaluate the inter-participant agreement in the selection of frequently occurring symptoms for the description of seizure types.
  
  
  METHODS
  We compared the actual agreement among participants with the agreement that would result from random symptom selection as well as with the maximal agreement attainable. For each seizure type we calculated the reliability coefficients of the responses.
  
  
  RESULTS
  For all seizure types we found that the agreement in symptom selection among the participants is significantly higher than expected by chance, but not reaching the maximum agreement attainable. The reliability coefficients varied between 0.56 and 0.74 for the various seizure types.
  
  
  CONCLUSIONS
  Although the participants do not reach the maximum agreement attainable in the selection of symptoms, the majority agreement on characteristic frequently occurring symptoms for the different seizure types does approach the maximum agreement attainable. Therefore, we conclude that expert opinions can be used for building descriptions of seizure types. However, to derive a reliable set of symptoms for the construction of the diagnostic reference frames (DRFs) more participants are needed.
authors.affiliation: Department of Medical Informatics, University of Maastricht, PO Box 616, 6200 MD Maastricht, Netherlands. w.vanast@mi.unimaas.nl
authors.forename: J F
authors.initials: JF
authors.lastname: van Ast
authors.forename: J L
authors.initials: JL
authors.lastname: Talmon
authors.forename: W O
authors.initials: WO
authors.lastname: Renier
authors.forename: P P M
authors.initials: PP
authors.lastname: Ahles
authors.forename: A
authors.initials: A
authors.lastname: Hasman
mesh_terms: D003658:Decision Making, Computer-Assisted; D003937:Diagnosis, Differential; D006801:Humans; D016347:Medical Records Systems, Computerized; D015588:Observer Variation; D012016:Reference Values; D015203:Reproducibility of Results; D012640:Seizures / Q000145:classification*