The interrater reliability of physical signs in patients with eating disorders.

OBJECTIVE

To evaluate the interrater reliability of five common signs of eating disorders.

METHODS

Eating disorder patients with anorexia nervosa, bulimia nervosa, and eating disorders not otherwise specified (ED-NOS), at various stages of recovery, were evaluated for the presence or absence of lanugo hair, acrocyanosis, parotid hypertrophy, hypercarotinemia, and Russell's sign. Patients were examined by two physicians with similar experience and training. Results are analyzed for reliability using the kappa statistic.

RESULTS

Kappa scores were as follows, indicating marginal reproducibility of results: lanugo hair (kappa = 0.606), acrocyanosis (kappa = 0.014), parotid hypertrophy (kappa = 0.266), hypercarotinemia (kappa = 0.101) , and Russell's sign (kappa = 0.140).

CONCLUSION

The interrater reliability for individual items ranged from poor to moderate. Overall, there is marginal interrater reliability for the five common signs of eating disorders assessed.