Summary measures of agreement and association between many raters’ ordinal classifications

Interpretation of screening tests such as mammograms usually require a radiologist's subjective visual assessment of images, often resulting in substantial discrepancies between radiologists' classifications of subjects' test results. In clinical screening studies to assess the strength of agreement between experts, multiple raters are often recruited to assess subjects' test results using an ordinal classification scale. However, using traditional measures of agreement in some studies is challenging due to the presence of many raters, the use of an ordinal classification scale and unbalanced data.

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