Agreement on medical fitness for a job.
五位职业医师独立评估180名求职者的医学适宜性，发现医师间及与官方服务的一致性差，平均31%的不合格判定被其他医师推翻，质疑了医学适宜性判断的有效性。
Five experienced occupational physicians independently reviewed the uniformly structured, concise records of 180 applicants who had applied for a job in one of three categories. All had undergone a preemployment medical examination by the Governmental Occupational Health and Safety Service. Agreement was assessed by calculating the percentage of disagreement and Cohen's kappa. Agreement between the five panel physicians and between the panel physicians and the Service appeared to be poor, with overall percentages of disagreement of 31 and 37%, respectively, and kappa values of 0.38 and 0.37, respectively. On the average 31% of the applicants judged as unfit by one physician had been assessed as fit by the others, whereas agreement was only marginally better when detailed medical criteria for fitness were available. Lack of consensus on the medical fitness of an applicant, as evidenced by this study, suggests that the validity of such a judgment may be questionable even when detailed fitness criteria are available.