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Coefficient κ is generally defined in terms of procedures of computation rather than in terms of a population. Here a population definition is proposed. On this basis, the interpretation of κ as a measure of diagnostic reliability in characterizing an individual, and the effect of reliability, as measured by κ , on estimation bias, precision, and test power are examined. Factors influencing the magnitude of κ are identified. Strategies to improve reliability are proposed, including that of combining multiple unreliable diagnoses.
Helena C. Kraemer (Sat,) studied this question.