Reliability of nutrition diagnostic codes and their defining characteristics

The purpose of this project was to evaluate the reliability of nutrition diagnostic codes and their defining characteristics when used within the context of case scenarios by Registered Dietitians (RDs) at three levels of practice. RDs were asked to select up to seven nutrition diagnostic labels from a list of 60 for each of six scenarios, with each scenario having two parts (12 scenarios). After completing the scenarios, participants rated their level of certainty that defining characteristics were needed to identify a subset of eight nutrition diagnostic labels.; Chi-square was used to evaluate between group differences in percent agreement on nutrition diagnostic labels for labels with greater than 60% agreement by all participants (N = 279). Factor analysis was used to determine if there were clusters of labels selected for a given scenario. Analysis of variance (ANOVA) was used to determine group differences in the number of nutrition diagnoses selected for each scenario. Kruskal-Wallis tests and ANOVA were used to identify group differences in level of certainty for the defining characteristics (N = 292). ANOVA was then used to determine if there were group differences in weighted mean rating of major and minor defining characteristics.; There were 34 labels with greater than 60% agreement and 10 with greater than 80% agreement by all participants. Of these, there were between group differences in selection of one, "Physical inactivity". A significantly lower percentage of entry-level RDs selected this label than did expert RDs (p = 0.005). Clusters of nutrition diagnostic labels were identified for 10 of the 12 scenarios. ANOVA testing revealed no significant differences between groups in the number of labels selected. There was good agreement between groups on level of certainty for all of the defining characteristics for five of eight labels and for most of the defining characteristics for the remaining three. RDs were also able to identify major and minor defining characteristics with good agreement.; RDs at three levels of practice agree on choice of nutrition diagnostic labels although more research is needed for those labels that did not reach 60% agreement. RDs selected the same number of labels for each scenario, implying that the terminology can be used at each of the three levels of practice. It is possible to identify major and minor defining characteristics using weighted mean ratings. Therefore, it can be recommended that implementation of the Standardized Language of Dietetics proceed.