01733nas a2200265   4500000000100000008004100001260001300042653002600055653001100081653001200092653003100104653003000135653003000165100001500195700001300210700001400223700001500237245005700252856005100309300001000360490000700370050001800377520105800395022001401453       2004                            d  c2004 Jun10aDisability Evaluation10aHumans10aleprosy10aReproducibility of Results10aSeverity of Illness Index10aWorld Health Organization1 aBrandsma W1 aLarsen M1 aRichard C1 aEbenezer M00aInter-rater reliability of WHO 'disability' grading.  uhttps://leprosyreview.org/article/75/2/13-1134  a131-40 v75  aBRANDSMA 20043 a<p>The World Health Organization 'disability' grading system was introduced in 1960. It is mainly used as an indicator for early diagnosis or reporting. Disability grades are usually aggregated at national levels. Comparison of data with previous years or comparison of data between programmes may show that patients report earlier for treatment, alternatively, are diagnosed earlier, that is without, or with fewer 'disabilities'. Despite its long and universal use as an epidemiological parameter, the WHO disability grading has not been the subject of reliability studies. In this study, three testers unfamiliar with the grading prior to the study each graded 65 (former) leprosy affected persons. The weighted kappa ranged from 0.87 to 0.89 (95% CI 0.73-1.00) for the highest score and from 0.90 to 0.96 (95% CI 0.90-0.99) for the EHF (Eye, Hand, Foot) score, indicating excellent reliability. The study shows that with limited training and little experience a high degree of reliability in grading 'disabilities' between testers is attainable.</p>  a0305-7518