[The accuracy and reproducibility of clinical examination of adenoma of the thyroid--corrected for randomness with iota and kappa].

: The aim of this study was to evaluate the reliability (accuracy and observer variability) of the clinical examination of the thyroid gland for adenomatous changes. All patients (n = 105) admitted for scintigraphic examination of the thyroid gland were examined by three observers and the thyroid scintigraphy was performed. The study population consisted of the patients (n = 84), where the result of the scintigraphic examination could be classified as either "normal" (n = 24), "solitary adenoma" (n = 32) or "nodular goitre" (n = 28), with scintigraphy used as golden standard. The accuracy was evaluated using each observer's sensitivity, specificity and total agreement with the golden standard for each diagnosis and the observer variability by the overall agreement between each pair of observers. After random agreement was eliminated by calculation of iota and kappa, the results showed a fair reliability of the clinical diagnoses "normal" and "solitary adenoma" (iota between 0.20 and 0.62; kappa between 0.33 and 0.46), but poor reliability for "nodular goitre", (iota between 0.00 and 0.50, kappa between 0.00 og 0.46). Calculation of the newly introduced iota is discussed in the appendix.