Fiabilidad interjueces en el contexto clínico: aplicación del método DOMENIC (Detección de Múltiples Examinadores No Consensuados) en la evaluación de la manía

Abstract

Objective

The diagnosis of bipolar disorder generates discrepancies among clinicians, impacting its treatment. We explored the inter-rater reliability of the Young Mania Rating Scale (YMRS) in a clinical setting, using the Detection of Multiple Examiners with No Consensus (DOMENIC) method, to determine whether there were differences in the level of agreement obtained by raters trained in the use of the YMRS versus untrained raters with greater clinical experience.

Method

Forty-four raters (12 trained in the scale and 32 untrained) viewed an interview with a patient diagnosed with bipolar disorder and completed the YMRS. We used the DOMENIC method to obtain the level of agreement.

Results

The average inter-rater agreement ranged from 47% to 100%. Trained raters showed agreement ≥ 79% on 7 of the 11 items, while untrained raters only achieved agreement on 3 of the 11 items.

Conclusions

Specific training in the use of the YMRS is key to achieving optimal levels of inter-rater reliability, regardless of clinical experience. The DOMENIC method allows for identifying the percentage of inter-rater agreement and comparing each rater with the rest of the group, facilitating rater training.