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Titolo:
Comparison of official coders versus physician panel in assignment of underlying cause of death
Autore:
Lu, TH; Chang, HY; Hwu, CM; Chiu, HC; Yin, WH; Pan, WH;
Indirizzi:
Acad Sinica, Inst Biomed Sci, Taipei 115, Taiwan Acad Sinica Taipei Taiwan 115 inica, Inst Biomed Sci, Taipei 115, Taiwan Chung Shan Med & Dent Coll Hosp, Dept Family Med, Taichung, Taiwan Chung Shan Med & Dent Coll Hosp Taichung Taiwan y Med, Taichung, Taiwan Natl Hlth Res Inst, Div Hlth Policy Res, Taipei, Taiwan Natl Hlth Res Inst Taipei Taiwan t, Div Hlth Policy Res, Taipei, Taiwan Taipei Vet Gen Hosp, Sect General Med, Dept Med, Taipei, Taiwan Taipei VetGen Hosp Taipei Taiwan General Med, Dept Med, Taipei, Taiwan Shin Kong Wu Ho Su Mem Hosp, Dept Neurol, Taipei, Taiwan Shin Kong Wu Ho Su Mem Hosp Taipei Taiwan , Dept Neurol, Taipei, Taiwan Cheng Hsin Gen Hosp, Dept Internal Med, Div Cardiol, Taipei, Taiwan Cheng Hsin Gen Hosp Taipei Taiwan rnal Med, Div Cardiol, Taipei, Taiwan
Titolo Testata:
JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION
fascicolo: 6, volume: 100, anno: 2001,
pagine: 365 - 369
SICI:
0929-6646(200106)100:6<365:COOCVP>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
MORTALITY STATISTICS; CERTIFICATION; ACCURACY;
Keywords:
cardiovascular disease; cardiovascular mortality; cause of death; classification methods; comparative study; clinical trial;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Pan, WH Acad Sinica, Inst Biomed Sci, 128,Sect 2,Acad Rd,Nan Kang, Taipei 115, Taiwan Acad Sinica 128,Sect 2,Acad Rd,Nan Kang Taipei Taiwan 115 Taiwan
Citazione:
T.H. Lu et al., "Comparison of official coders versus physician panel in assignment of underlying cause of death", J FORMOS ME, 100(6), 2001, pp. 365-369

Abstract

Background and purpose: In outcome analyses of clinical trials and mortality follow up studies, the underlying cause of death (UCOD) is commonly assigned either by official coders or by a panel of physicians. We evaluated the validity of UCOD assigned by official coders by comparison with the assignments of a panel of physicians who reviewed the available medical records of the deceased. Methods: The comparisons focused on deaths occurring from October 1995 through June 1998 in a series of residents in a veterans home. Because of limited resources, only the first 104 deaths that occurred during the study period were included. Agreement rate, sensitivity, specificity, and kappa statistics were calculated to assess the consistency of coder versus physician panel assignment of UCOD by selected main causes of death. For 32 of the 104 deaths, the panel concluded that the information obtained from medical records was insufficient to determine the UCOD, and the following analyses were confined to the other 72 deaths. Results: For the 72 deaths considered by the panel to have sufficient information to determine UCOD, all four physicians agreed on a single UCOD in 50 (69%) cases, while three or four agreed in 66 (92%) cases. A consensus was reached in cases with disagreement. The two procedures completely agreed in 40 (56%) of the deaths. For general category UCOD, the kappa value was high for cancer (0.83) and cardiovascular disease (CVD, 0.73) but only moderate for pulmonary disease (PD, 0.60). When the UCOD assigned by the panel was used as the gold standard, official coders showed relatively low sensitivity for correct determination of UCOD in cases of CVD (0.76) compared withcancer (0.86) and PD (0.80). Conclusions: Given the high inter-physician consistency and the relativelylow sensitivity of official coders in assigning CVD as the UCOD, we conclude that the use of clinical review panels would provide more accurate UCOD assignments for use in outcome analyses in mortality follow-up studies and clinical trials in Taiwan.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 07:51:29