can we exclude the possibility that characteristics of OD in the specific population we studied contributed to a more homogeneous phenotypic presentation. Importantly, the high (but not extreme) rates of OD in our inter-rater reliability sample would not have contributed to inflated estimates of κ, but rather more reliable ones (i.e., as κ is less robust in instances where the base rate of the trait is either very high or very low; e.g., >95% or <5%) (Spitznagel & Helzer, 1985).
