Coefficient κ is generally defined in terms of procedures of computation rather than in terms of a population. Here a population definition is proposed. On this basis, the interpretation of κ as a measure of diagnostic reliability in characterizing an individual, and the effect of reliability, as measured by κ, on estimation bias, precision, and test power are examined. Factors influencing the magnitude of κ are identified. Strategies to improve reliability are proposed, including that of combining multiple unreliable diagnoses.