01904nas a2200301   4500000000100000008004100001260001700042653001000059653001000069653001100079653001100090653001200101653000900113653002300122653003200145100001400177700002000191700001500211700001700226700001700243700001300260245008800273300001100361490000700372050003200379520117700411022001401588       1990                            d  c1990 Jul-Sep10aAdult10aChild10aFemale10aHumans10aleprosy10aMale10aObserver Variation10aSensitivity and Specificity1 aGupte M D1 aVallishayee R S1 aNagaraju B1 aRamalingam A1 aLourdusamy G1 aKannan S00aInter-observer agreement and clinical diagnosis of leprosy for prophylaxis studies.  a281-950 v62  aInfolep Library - available3 a<p>Clinical diagnosis is still the most useful tool for detecting early cases of leprosy in field research. In prophylaxis studies accuracy of clinical diagnosis of leprosy is important during intake as well as for measuring efficacy of the intervention. This paper reports our observations regarding the extent of inter-observer variations in clinical diagnosis of leprosy and its implications for a prophylaxis study. Information on 225 suspects and cases of leprosy, each examined independently by three senior workers after initial standardization, was used for this purpose. Agreement among the examiners regarding the presence of skin patch, thickened nerve trunk and sensory deficit was fairly high (Kappa = 0.7). Agreement on the presence of infiltration in a skin patch was not satisfactory (Kappa = 0.4-0.5). It was observed that in clinical diagnosis of leprosy, presence of skin patch and sensory deficit, as well as thickened nerve trunk and related anaesthesia were correlated observations. The influence of inter-observer variations on defining leprosy problem in the community can be quite large. The paper suggests some ways of overcoming the problem.</p>  a0254-9395