title: How reliable is the Spanish bodily harm assessment scale?
abstract: The use of scales to quantify or qualify bodily harm resulting from an unintentional car accident has been mandatory in Spain since 1995 and compensation for personal injuries resulting from a traffic accident is calculated according to a legal ruling established by Royal Decree 8/2004 (RDL). This present study assesses the reliability of the scale. Agreement between the evaluations for the same patient by 24 qualified observers following the Royal Decree 8/2004 was measured using the Kappa index. The variables assessed were the days of hospitalization, impeditive days, non impeditive days and the functional and aesthetic sequelae. The application of the Fleiss Kappa index obtained a result of 0.37, indicating a "fair agreement" according to the rating scale proposed by Landis and Koch. This study demonstrates the unreliability of the Spanish medical scale for the assessment of injury as described in the RDL 8/2004. The scale should adopt the measurement systems and clinical classifications of outcomes such as the ASIA, SCI scale or the Daniels scale of neurological injury and allow scientific discussion of the findings of the report. The resulting quantitative value should operate as a reliable indicator of a specific quality of the damage.
authors.affiliation: Institute of Forensic Sciences University of Santiago de Compostela, Spain.
authors.forename: Lucía
authors.initials: L
authors.lastname: Ordóñez-Mayán
authors.affiliation: Institute of Forensic Sciences University of Santiago de Compostela, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Represas
authors.affiliation: Rehabilitation Service, Complexo Piñor Hospital University Hospital of Ourense, Spain.
authors.forename: Xoan
authors.initials: X
authors.lastname: Miguéns
authors.affiliation: Institute of Forensic Sciences University of Santiago de Compostela, Spain; Department of Pathology and Forensic Sciences, University of Santiago de Compostela, Spain.
authors.forename: María Sol
authors.initials: MS
authors.lastname: Rodríguez-Calvo
authors.affiliation: Department of Statistics and Operations Research, University of Santiago de Compostela, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Febrero-Bande
authors.affiliation: Institute of Forensic Sciences University of Santiago de Compostela, Spain; Department of Pathology and Forensic Sciences, University of Santiago de Compostela, Spain. Electronic address: joseignacio.munoz.barus@usc.es.
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Muñoz-Barús
mesh_terms: D000063:Accidents, Traffic; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results; D013030:Spain / Q000453:epidemiology; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification*
keywords: Assessment bodily harm; RDL 8/2004; Reliability; Scale