What is a generally acceptable inter-rater reliability (kappa) value in CDI chart audits?

• A. Values below 0.2 are acceptable.
• B. Values between 0.3 and 0.5 are acceptable.
• C. Values above 0.70 are generally acceptable; 0.8+ indicates strong agreement, though thresholds may vary by policy.
• D. Kappa values are not used in CDI audits.

Answer: (C)

Inter-rater reliability in CDI chart audits is measured with Cohen’s kappa, which gauges how much two reviewers agree beyond what would be expected by chance. A kappa above about 0.70 is typically viewed as acceptable reliability, with values around 0.80 or higher indicating strong agreement. This nuance matters because kappa adjusts for the possibility that reviewers might agree simply by guessing or due to imbalanced category prevalence, not because they truly align in their judgments.

So the best answer aligns with common practice: values above 0.70 are generally acceptable, and 0.8 or higher shows strong agreement, with specific thresholds potentially varying by policy. The other options suggest too low a standard or deny the use of kappa altogether, which isn’t accurate for CDI audits.