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Table 4 Typical example of the direct versus the inferred assignment of one of the readers

From: Expert agreement confirms that negative changes in hand and foot radiographs are a surrogate for repair in patients with rheumatoid arthritis

Reader's direct judgement (direct assignment) Reader's better/worse interpretation in combination with true time order of X-rays (inferred assignment): Totals
  Compatible with progression or no change Compatible with repair  
Progression/no change 21 15 36
Repair 1 27 28
Totals 22 42 64
  1. The inferred assignment is considered the gold standard. Direct assignment underestimates the true prevalence of repair. Percentage correctly classified, 75%; false direct assignment of repair, 1.5%; false direct assignment of progression, 23%; positive predictive value, 96%; negative predictive value, 58%.