The Reliability of Clinical Diagnoses: State of the Art

Annual Review of Clinical Psychology

Vol. 10:111-130 (Volume publication date March 2014)
First published online as a Review in Advance on January 2, 2014
https://doi.org/10.1146/annurev-clinpsy-032813-153739

Helena Chmura Kraemer

Department of Psychiatry and Behavioral Sciences, Stanford University (Emerita), Palo Alto, California 94301; and Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213; email:

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Abstract

Reliability of clinical diagnosis is essential for good clinical decision making as well as productive clinical research. The current review emphasizes the distinction between a disorder and a diagnosis and between validity and reliability of diagnoses, and the relationships that exist between them. What is crucial is that reliable diagnoses are essential to establishing valid diagnoses. The present review discusses the theoretical background underlying the evaluation of diagnoses, possible designs of reliability studies, estimation of the reliability coefficient, the standards for assessment of reliability, and strategies for improving reliability without compromising validity.

Keywords

validity, disorder, design, kappa

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