Inter- and Intra-Rater Reliability of the Thai Version of SCAN: Use of Alcohol and Use of Tobacco Section
Suwanna Arunpongpaisal MD*, Thawatchai Krisanaprakornkit MD*, Suchat Paholpak MD*, Jiraporn Keiwyoo PhD**
Affiliation : * Departments of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen ** Department of Biostatistics and Demography,Faculty of Public Health, Khon Kaen University, Khon Kaen
Objective : To assess inter and intra rater reliability of the Thai version of Use of Alcohol and Use of Tobacco
Section of the WHO Schedules for Clinical Assessment in Neuropsychiatry (SCAN).
Materials and Methods : Fifteen alcohol and/or tobacco dependence patients and fifteen controls with ages of
> 18 years were recruited from October 2003 to August 2004 at Srinagarind Hospital. One psychiatrist
interviewed and first rated under video-recording, then re-rated two weeks later. Another psychiatrist rated
independently by looking at the videotapes for inter-rater reliability testing.
Results : The intra-rater kappa was ‘excellent’ for both sections. The inter-rater kappa for all items of “tobacco
use” were ‘excellent’(mean κ =0.84), and ‘good’(mean κ =0.66) for the “alcohol use”. Items of dependence
had ‘good’ kappa (mean κ =0.73-0.95), except items of ‘activities limitation (interest neglect)’ and ‘use
despite knowledge of psychological/physical problems (continued use)’ was ‘fair’ (mean κ 062-0.49). The
poor kappa (mean κ =0.17-0.38) was found in the item of ‘physical and mental health problems due to
drinking’.
Conclusion : Thai SCAN provided reliable inter-rater diagnostic information for alcohol and tobacco
dependence, but fair reliability for alcohol abuse. Improve understanding of the item concepts, better validity
in questioning; giving examples of the focus symptoms, and frequent discussion about the respondent’s answers,
might improve overall validity and reliability.
Keywords : Inter rater reliability, Intra-rater reliability, SCAN, Schedules for clinical assessment in neuropsy- chiatry,Alcohol use disorder, Tobacco use disorder,Validity
