[Interobserver agreement in the diagnosis and management of foot warts]

Abstract

The interobserver agreement in diagnosing the presence or the disappearance of plantar wart was assessed among ten Family Physicians from the Family Medicine Unit (FMU) of the Centre hospitalier de l'Université Laval (CHUL). Physicians were trained to recognize predetermined clinical criteria for the presence (microthrombi, interruption of skin folds and hyperkeratosis) and disappearance (return of skin folds) of plantar warts. Sixty (60) untreated plantar lesions in 43 patients were examined independently by two to five available physicians. Twenty-two (22) patients who came for one to six follow-up visits generated 77 post treatment assessments of plantar warts. The observed agreement was 82% for diagnosis (49/60) and for cure (63/77). The agreement corrected for chance as measured by the Kappa coefficient was 0.60 for diagnosis and 0.61 for cure. A good degree of agreement on diagnosis and disappearance of plantar wart was achieved among the FMU physicians.