Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Assessment of Assistant Physicians' Competencies for Making Accurate Diagnosis with Agreement Coefficients: A Methodological Study
Asistan Hekimlerin Doğru Tanı Koyabilme Yeterliliklerinin Uyum Katsayıları ile Değerlendirilmesi: Metodolojik Bir Çalışma
İsmet DOĞANa, Nurhan DOĞANa
aDepartment of Biostatistics and Medical Informatics, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Türkiye
Turkiye Klinikleri J Med Sci. 2023;43(1):14-21
doi: 10.5336/medsci.2022-88728
Article Language: EN
Full Text
ABSTRACT
 Objective: The objective of this study is to introduce some statistical methods, which are thought to be used in evaluating the ability of resident physicians to make the correct diagnosis, with a sample application. Material and Methods: The most common way to show the accuracy of a decision maker's decisions relative to the decisions to be referenced is to construct an error matrix. In the ideal case, all off-diagonal elements of the error matrix would have a value of zero, indicating that no decision of the decision maker was wrong with respect to the reference. The calculations of the methods in the study are shown on a sample error matrix. The data in the error matrix are randomly derived data. In the evaluation of the error matrix, the agreement coefficients suggested by Bishop et al., Helldén and Short were used. Results: When the decisions of the decision maker (assistant physician) and the reference (specialist physician) decisions are similar, the variance of the error matrix decreases, the confidence intervals narrow, and the value of the coefficients of agreement both in the categorical and in general increases. Conclusion: Objective assessment techniques rather than subjective assessment are important for the standardization and quality of education. According to the findings, it was concluded that the agreement coefficients for proficiency in specialization education are usable and the quality of education will increase if they are used together with other evaluation methods.

Keywords: Specialization education; categorical agreement; competence; making a diagnosis
ÖZET
 Amaç: Bu çalışmanın amacı, asistan hekimlerin doğru tanı koyma yeterliliklerinin değerlendirilmesinde kullanılabileceği düşünülen bazı istatistiksel yöntemleri örnek bir uygulama ile tanıtmaktır. Gereç ve Yöntemler: Bir karar vericinin vermiş olduğu kararların referans kararlara göre doğruluğunu göstermenin en yaygın yolu bir hata matrisi oluşturmaktır. İdeal durumda, hata matrisinin tüm köşegen dışı elemanlarının değeri sıfır olur ve bu da referansa göre karar vericinin hiçbir kararının yanlış olmadığını gösterir. Çalışmada yer alan yöntemlerin hesaplamaları örnek bir hata matrisi üzerinde gösterilmiştir. Hata matrisinde yer alan veriler rastgele türetilmiş verilerdir. Hata matrisinin değerlendirilmesinde Bishop ve ark., Helldén ve Short tarafından önerilen uyum katsayıları kullanılmıştır. Bulgular: Karar verici (yardımcı hekim) kararları ile referans (uzman hekim) kararları birbirine benzedikçe hata matrisine ait varyans küçülmekte, güven aralıkları daralmakta, gerek kategori gerekse genel olarak uyum katsayılarının değeri büyümektedir. Sonuç: Öznel değerlendirmeden ziyade nesnel değerlendirme teknikleri eğitimin standardizasyonu ve kalitesi için önemlidir. Elde edilen bulgulara göre uzmanlık eğitiminde yeterlilik için uyum katsayılarının kullanılabilir olduğu ve diğer değerlendirme yöntemleri ile birlikte kullanılması hâlinde eğitimin kalitesinin yükseleceği sonucuna ulaşılmıştır.

Anahtar Kelimeler: Uzmanlık eğitimi; kategorik uyum; yeterlilik; tanı koyma
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