In study 1, laboratory and supervised blood or urine test data from actual cases were used to develop patient profiles. Seven diabetologists from the same institution rated the diabetic control of 125 profiles on a four-point scale (1 = poor, 2 = fair, 3 = good, 4 = excellent). Six of the 7 diabetologists demonstrated adequate intra- and interrater reliability. Study 2 assessed the reliability of judgments of diabetic control made by diabetologists working in two different settings. There were 9 raters from institution 1 and8 from institution 2. The impact of the amount and type of information on judgment reliability was evaluated by developing two types of profiles. The test form contained only laboratory and supervised blood or urine test data similar to that utilized in study 1. The history form contained this information as well as other descriptive data typically available to diabetologists. The 17 diabetologists rated 125 anonymous profiles on each of twoseparate occasions ∼ 1 wk apart. On one occasion they rated profiles presented on the test form. On the other occasion they rated profiles presented on the history form. As in study 1, the diabetologist raters demonstrated adequate intra- and interrater reliability. Intrarater reliability was somewhat better when rating test form profiles compared with history form profiles. Reliability was not higher within than between institutions. Ananalysis of the relative contribution of different diabetes control indices to the diabetologists' judgments indicated that HbA1 influenced raters' judgmentsat both institutions more than any other single variable. However, raters utilized other information as well, particularly the urine test and fasting blood glucose results. Use of a cholesterol measure by institution 2 raters, but not by institution 1 raters, was theonly clearly discrepant use of test form data by the diabetologists working in two different settings. A mathematical prediction equation was developed that accurately simulated the diabetologists' judgments. The robustness of this equation was tested and demonstrated on a cross-validation sample of the cases utilized in study 1.
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Original Articles|
March 01 1987
Diabetologists' Judgments of Diabetic Control: Reliability and Mathematical Simulation
Marika Spevack, MS;
Marika Spevack, MS
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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Suzanne Bennett Johnson, PhD;
Suzanne Bennett Johnson, PhD
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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Jill M Harkavy, PhD;
Jill M Harkavy, PhD
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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Janet Silverstein, MD;
Janet Silverstein, MD
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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Jon Shuster, PhD;
Jon Shuster, PhD
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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Arlan Rosenbloom, MD;
Arlan Rosenbloom, MD
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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John Malone, MD
John Malone, MD
Departments of Clinical Psychology, Psychiatry, Pediatrics, and Statistics, University of Florida
Gainesville
, and the Department of Pediatrics, University of South Florida
Tampa, Florida
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Address correspondence and reprint requests to Suzanne B. Johnson, PhD, Department of Psychiatry, Box J-234, J. Hillis Miller Health Center, Gainesville, FL 32610.
Citation
Marika Spevack, Suzanne Bennett Johnson, Jill M Harkavy, Janet Silverstein, Jon Shuster, Arlan Rosenbloom, John Malone; Diabetologists' Judgments of Diabetic Control: Reliability and Mathematical Simulation. Diabetes Care 1 March 1987; 10 (2): 217–224. https://doi.org/10.2337/diacare.10.2.217
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