Citation

Sachs CJ, Benson A, Schriger DL, Wheeler M. J. Forensic Nurs. 2011; 7(4): 190-194.

Affiliation

Medicine/Emergency Medicine, University of California School of Medicine, Los Angeles, California Department of Nursing, California State University, Long Beach, California Medicine/Emergency Medicine, University of California School of Medicine, Los Angeles, California Forensic Nurse Specialists, Inc., Long Beach, California.

Copyright

(Copyright © 2011, International Association of Forensic Nurses, Publisher John Wiley and Sons)

DOI

10.1111/j.1939-3938.2011.01117.x

PMID

22123039

Abstract

Objective: To establish inter-rater reliability for genital injury detection among experienced forensic sexual assault (SA) examiners. Methods: Cross-sectional observational study testing inter-rater agreement of injury assessment among eight experienced SA examiners who each viewed 2-4 digital images from 50 cases. Each case was rated by 4 examiners and included images before and after toluidine blue dye application. We calculated overall agreement and kappa (κ). Results: Examiners had perfect agreement in 60 cases; in 24 cases 3 examiners agreed; in 5 cases 2 agreed and 1 was unsure; and in 9 cases there were 2 "yes" and 2 "no" ratings or 1 "yes," 1 "no," and 2 "unsure" ratings. Overall agreement was 82% (κ, 0.57) when yes|unsure and no|unsure combinations equaled disagreement and 86% (κ, 0.66) when only yes|no dyads equaled disagreement. Neither the number of images nor any single examiner fundamentally influenced results. Highly experienced examiners tended to agree with each other (86%) slightly more often than moderate examiners agreed with each other (75%). Conclusions: Our set of experienced forensic examiners achieved moderate inter-rater agreement in assessment of the presence of female genital injury on selected digital images obtained during SA examination.

Language: en