Abstract：
OBJECTIVE: This study aimed to evaluate the concordance of eating disorders (EDs) diagnoses within a multidisciplinary team in a specialized hospital unit dedicated to the medical care of ED.
METHODS: The study analyzed data from 608 female patients who sought consultation at the Eating Disorders Referral Center between 2017 and 2021. The diagnoses were established according to the DSM-5 criteria by endocrinologists, psychiatrists, and finally confirmed or discussed within a monthly multidisciplinary consensus meeting (MCM). Fleiss\' Kappa tests were conducted to assess inter-raters\' agreement.
RESULTS: Overall, substantial agreement was observed between endocrinologists and psychiatrists and the MCM. A more detailed analysis revealed variations in agreement across different disorders. Certain EDs demonstrated substantial agreement (e.g., anorexia nervosa restrictive subtype), while others approached near-perfect agreement (e.g., binge-eating disorder). In contrast, agreement was fair to poor for anorexia nervosa binge-purge subtype (ANBP) and slight for other specified feeding and ED. A period of temporary disagreement was noted for ANBP, partially attributed to practitioner turnover. An improvement in interdisciplinary agreement was observed for all ED diagnoses by the end of the study period.
CONCLUSIONS: Variations or lower levels of inter-rater agreement may stem from atypical cases that fall on the border between two diagnoses or complex cases, as well as fluctuating symptoms. The progress observed throughout the study can be attributed in part to interdisciplinary learning, particularly facilitated by the MCM. The findings underscore the significance of striving for optimal concordance among different medical specialties to enhance patient care in ED treatment.
UNASSIGNED: This study scrutinizes the agreement levels of ED diagnoses among endocrinologists and psychiatrists within a multidisciplinary team at an Eating Disorders Referral Center. While substantial overall agreement was achieved, disparities or lower agreement levels were evident for certain diagnoses such as anorexia nervosa binge-purge subtype. However, collaborative meetings led to a progressive enhancement in agreement over time. This research underscores the crucial role of a multidisciplinary team working collectively to ensure precise diagnoses and improved care for patients with EDs.
METHODS: The study analyzed data from 608 female patients who sought consultation at the Eating Disorders Referral Center between 2017 and 2021. The diagnoses were established according to the DSM-5 criteria by endocrinologists, psychiatrists, and finally confirmed or discussed within a monthly multidisciplinary consensus meeting (MCM). Fleiss\' Kappa tests were conducted to assess inter-raters\' agreement.
RESULTS: Overall, substantial agreement was observed between endocrinologists and psychiatrists and the MCM. A more detailed analysis revealed variations in agreement across different disorders. Certain EDs demonstrated substantial agreement (e.g., anorexia nervosa restrictive subtype), while others approached near-perfect agreement (e.g., binge-eating disorder). In contrast, agreement was fair to poor for anorexia nervosa binge-purge subtype (ANBP) and slight for other specified feeding and ED. A period of temporary disagreement was noted for ANBP, partially attributed to practitioner turnover. An improvement in interdisciplinary agreement was observed for all ED diagnoses by the end of the study period.
CONCLUSIONS: Variations or lower levels of inter-rater agreement may stem from atypical cases that fall on the border between two diagnoses or complex cases, as well as fluctuating symptoms. The progress observed throughout the study can be attributed in part to interdisciplinary learning, particularly facilitated by the MCM. The findings underscore the significance of striving for optimal concordance among different medical specialties to enhance patient care in ED treatment.
UNASSIGNED: This study scrutinizes the agreement levels of ED diagnoses among endocrinologists and psychiatrists within a multidisciplinary team at an Eating Disorders Referral Center. While substantial overall agreement was achieved, disparities or lower agreement levels were evident for certain diagnoses such as anorexia nervosa binge-purge subtype. However, collaborative meetings led to a progressive enhancement in agreement over time. This research underscores the crucial role of a multidisciplinary team working collectively to ensure precise diagnoses and improved care for patients with EDs.
摘要：
目的：本研究旨在评估饮食失调（ED）诊断的一致性，该研究是在专门为ED提供医疗服务的专科医院的多学科团队中进行的。
方法：该研究分析了2017年至2021年在饮食失调转诊中心寻求咨询的608名女性患者的数据。诊断是由内分泌学家根据DSM-5标准建立的，精神病医生,最后在每月的多学科共识会议（MCM）中确认或讨论。进行了Fleiss\'Kappa测试以评估评估者之间的协议。
结果：总体而言，在内分泌学家和精神科医生与MCM之间观察到了实质性的一致性。更详细的分析显示，不同疾病之间的一致性存在差异。某些ED表现出实质性的协议(例如，神经性厌食症限制性亚型)，而其他人则接近完美的协议(例如，暴饮暴食症)。相比之下,对于神经性厌食症暴饮暴食亚型（ANBP），协议是公平的，对于其他指定的喂养和ED，协议是轻微的。ANBP出现了暂时的分歧，部分归因于从业者的营业额。到研究期结束时，所有ED诊断均观察到跨学科一致性的改善。
结论：评估者之间协议的差异或较低水平可能源于两次诊断之间的边界上的非典型病例或复杂病例，以及波动的症状。在整个研究中观察到的进展可以部分归因于跨学科学习，特别是在MCM的推动下。研究结果强调了在不同医学专业之间努力实现最佳一致性以增强ED治疗中患者护理的重要性。
本研究在饮食失调转诊中心的多学科团队中，对内分泌学家和精神科医生之间ED诊断的一致水平进行了审查。虽然达成了实质性的总体协议，对于某些诊断,如神经性厌食症暴饮暴食清除亚型,差异或较低的一致水平是明显的.然而,随着时间的推移，合作会议导致了协议的逐步加强。这项研究强调了多学科团队共同努力的关键作用，以确保对ED患者的精确诊断和改善护理。
方法：该研究分析了2017年至2021年在饮食失调转诊中心寻求咨询的608名女性患者的数据。诊断是由内分泌学家根据DSM-5标准建立的，精神病医生,最后在每月的多学科共识会议（MCM）中确认或讨论。进行了Fleiss\'Kappa测试以评估评估者之间的协议。
结果：总体而言，在内分泌学家和精神科医生与MCM之间观察到了实质性的一致性。更详细的分析显示，不同疾病之间的一致性存在差异。某些ED表现出实质性的协议(例如，神经性厌食症限制性亚型)，而其他人则接近完美的协议(例如，暴饮暴食症)。相比之下,对于神经性厌食症暴饮暴食亚型（ANBP），协议是公平的，对于其他指定的喂养和ED，协议是轻微的。ANBP出现了暂时的分歧，部分归因于从业者的营业额。到研究期结束时，所有ED诊断均观察到跨学科一致性的改善。
结论：评估者之间协议的差异或较低水平可能源于两次诊断之间的边界上的非典型病例或复杂病例，以及波动的症状。在整个研究中观察到的进展可以部分归因于跨学科学习，特别是在MCM的推动下。研究结果强调了在不同医学专业之间努力实现最佳一致性以增强ED治疗中患者护理的重要性。
本研究在饮食失调转诊中心的多学科团队中，对内分泌学家和精神科医生之间ED诊断的一致水平进行了审查。虽然达成了实质性的总体协议，对于某些诊断,如神经性厌食症暴饮暴食清除亚型,差异或较低的一致水平是明显的.然而,随着时间的推移，合作会议导致了协议的逐步加强。这项研究强调了多学科团队共同努力的关键作用，以确保对ED患者的精确诊断和改善护理。
