Abstract：
OBJECTIVES:The diagnostic accuracy of a clinical test is typically evaluated by comparing the classification of individuals by the test with their classification by some diagnostic gold standard. The most popular indices of diagnostic accuracy are sensitivity, specificity, and positive and negative predictive values. However, these measures are affected by the fact that some diagnostic decisions will be correct by chance, resulting in values that differ widely between indices, and clinicians may be confused as to whether results indicate that a test is good or poor. In keeping with the principle in evidence-based practice that decisions should be based on evidence not guesswork, we might expect that measures of diagnostic accuracy should therefore be chance corrected. The objective of this article was to advocate this and draw attention to indices that achieve this requirement. STUDY DESIGN AND SETTING:The principles underlying calculations of diagnostic accuracy are presented as a framework for understanding the problem and its solution. RESULTS:Disparities between different indices of diagnostic accuracy may be resolved by adjusting them to correct for chance effects. This produces a pair of weighted 2 x 2 "diagnostic" kappa coefficients offering a number of theoretical and practical advantages. CONCLUSION:Routine use of weighted 2 x 2 kappa coefficients as indices of diagnostic accuracy is recommended.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Gilchrist JMdoi
10.1016/j.jclinepi.2008.11.012subject
Has Abstractpub_date
2009-10-01 00:00:00pages
1045-53issue
10eissn
0895-4356issn
1878-5921pii
S0895-4356(08)00329-6journal_volume
62pub_type
杂志文章abstract：OBJECTIVES:To investigate the application of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and the quality of evidence ratings in systematic reviews of complex interventions. STUDY DESIGN AND SETTING:This study examined all 40 systematic reviews published in three Cochrane Rev...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2016.03.014
更新日期：2016-10-01 00:00:00
abstract：OBJECTIVES:To develop the first item bank to measure stress resilience (SR) in clinical populations. STUDY DESIGN AND SETTING:Qualitative item development resulted in an initial pool of 131 items covering a broad theoretical SR concept. These items were tested in n = 521 patients at a psychosomatic outpatient clinic. ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2018.04.004
更新日期：2018-08-01 00:00:00
abstract：OBJECTIVES:The STAndards for Reporting studies of Diagnostic accuracy (STARD) for investigators and editors and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) for reviewers and readers offer guidelines for the quality and reporting of test accuracy studies. These guidelines address and propose some solu...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2008.02.007
更新日期：2009-04-01 00:00:00
abstract：OBJECTIVES:Model specification-what adjusting variables are analytically modeled-may influence results of observational associations. We present a standardized approach to quantify the variability of results obtained with choices of adjustments called the "vibration of effects" (VoE). STUDY DESIGN AND SETTING:We estim...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.05.029
更新日期：2015-09-01 00:00:00
abstract：:Mortality rates in Denmark from ischemic heart diseases (IHD), other heart diseases and unknown causes are presented for the period 1968-92. In all age groups, mortality from IHD is higher at the beginning of the period than at the end. For other heart disease, the plot of the mortality rate is U-shaped for the age gr...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00158-m
更新日期：1995-04-01 00:00:00
abstract：:We studied the outcome in 308 patients with acute myocardial infarction (MI) admitted to the coronary care unit of Kobe General Hospital. Short-term outcome (within 28 days after MI) and long-term outcome (more than 28 days) were examined with survival curves to find any relationship with a history of previous MI and ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(92)90186-q
更新日期：1992-01-01 00:00:00
abstract：:Numerous studies have shown that the symptoms of angina pectoris are more prevalent in women than men, than other manifestations of coronary heart disease, with the greatest discrepancies at younger ages. Variation in symptom reliability between genders could be a potential explanation for these differences. The Lipid...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90009-x
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:Correspondence analysis (CA) is a multivariate graphical technique designed to explore the relationships among categorical variables. Epidemiologists frequently collect data on multiple categorical variables with the goal of examining associations among these variables. Nevertheless, CA appears to be an under...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2009.08.008
更新日期：2010-06-01 00:00:00
abstract：OBJECTIVES:Interpretation of clinical research findings using the paradigm of null hypothesis significance testing has a number of limitations. These include arbitrary dichotomization of results, lack of incorporation of study power and prior probability, and the confusing use of conditional probability. This study aim...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2017.08.016
更新日期：2017-12-01 00:00:00
abstract：:The objective of this study was to assess the effects of a multicomponent intervention on private pharmacy practice. From 641 private pharmacies in Hanoi, 68 pharmacies were randomly selected and matched into 34 pairs. Each pair consisted of a control and an intervention pharmacy. Three interventions were applied sequ...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0895-4356(02)00458-4
更新日期：2002-11-01 00:00:00
abstract：:In this project, we set out to identify ways to increase the uptake of core outcome sets in clinical research. In doing so, we uncovered a growing recognition, across many different health care sectors, of the need for common, relevant outcomes to improve the quality of decision-making. This has led to a plethora of p...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.05.016
更新日期：2019-12-01 00:00:00
abstract：OBJECTIVES:The objective of the study is to estimate the proportion of statistically significant survival improvements reported in randomized trials of cancer treatments that are also compatible with a clinically negligible benefit. STUDY DESIGN AND SETTING:This is a cross-sectional study of reports of randomized clin...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2020.06.026
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVES:To study the statistical power of randomized clinical trials and examine developments over time. STUDY DESIGN AND SETTING:We analyzed the statistical power in 136,212 clinical trials between 1975 and 2014 extracted from meta-analyses from the Cochrane database of systematic reviews. We determined study powe...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2018.06.014
更新日期：2018-10-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to study if randomized controlled trials (RCTs) in rehabilitation (a field where complex interventions prevail) published in main journals include all the details needed to replicate the intervention in clinical practice (clinical replicability). STUDY DESIGN AND SETTING:Forty...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.06.008
更新日期：2019-10-01 00:00:00
abstract：:Previous work has suggested that recall bias in case-control studies may be more serious when the overall study quality is lower. This paper summarizes a systematic literature search to examine the question. All relevant studies published between 1966 and 1990 were included if they met the following criteria: (1) they...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00132-a
更新日期：1995-02-01 00:00:00
abstract：:A key component in the evaluation of efficacy of a vaccine to protect against disease caused by an antigenically diverse infectious pathogen in a preventative vaccine trial is assessing how vaccine-induced protection depends on genotypic and phenotypic variations of the exposing pathogen. This assessment is made by co...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/s0895-4356(00)00258-4
更新日期：2001-01-01 00:00:00
abstract：OBJECTIVES:To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. STUDY DESIGN AND SETTING:Qualitative analysis of 73 audio recordings of recruitment consultations from fiv...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jclinepi.2018.02.018
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The determinants of guideline panels' recommendations remain uncertain. The objective of this study was to investigate factors considered by members of 8 panels convened by the American Society of Hematology (ASH) to develop guidelines using Grading of Recommendations Assessment, Development, ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2019.02.009
更新日期：2019-06-01 00:00:00
abstract：:This study assesses psychometric properties of the Modified Mini-Mental State Exam (3MS) and present population norms and demographic risk factors for low 3MS scores. The subjects were 885 persons aged 65 and older who took the 3MS as part of the Stirling County Study, a population-based longitudinal study of adult re...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00111-2
更新日期：2003-07-01 00:00:00
abstract：OBJECTIVE:In this study, we assessed the validity of maternally self-reported history of preeclampsia. STUDY DESIGN AND SETTING:This study was embedded in the Generation R Study, a population-based prospective cohort study. Data were obtained from prenatal questionnaires and one questionnaire obtained 2 months postpar...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2009.10.010
更新日期：2010-08-01 00:00:00
abstract：:The occurrence and number of melanocytic nevi are among the most important known risk factors for the development of malignant melanoma. Studying the causes of nevi should lead to successful strategies in the prevention of melanoma. Among 11,478 white German children of preschool age the association between benign mel...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(02)00484-5
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:A comprehensive picture of population health status can be captured by the incorporation of patient-reported outcome measures into population health monitoring. OBJECTIVE:The aim of the study was to identify the current state, opportunities, and future research related to the utilization of patient-reported...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2017.04.018
更新日期：2017-09-01 00:00:00
abstract：:Health researchers commonly use logistic regression when profiling health providers. Data from the patients treated by the providers are used to construct models predicting the expected number of outcomes for providers and the ratio of observed to expected outcomes (O/E ratio) used as a risk-adjusted measure of provid...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00048-9
更新日期：2003-06-01 00:00:00
abstract：:Mortality rates of 22,995 Finnish men aged 25 and over followed up for a median of 12 years were analyzed in relation to body mass index (BMI) at the initial examination. All-cause mortality followed a "U"-shaped distribution, being greatest for the thinnest and fattest men at all ages, or about 1.5-fold for those wit...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(89)90076-0
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:To assess the impact of including unpublished data on adverse effects in systematic reviews. STUDY DESIGN AND SETTING:We carried out a systematic review of methodological evaluations that compared the quantitative reporting of adverse effects data between published and unpublished sources, in particular, the...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2010.02.009
更新日期：2010-10-01 00:00:00
abstract：:In replication of two recent studies, it was intended to show that headache symptoms obtained by means of questionnaires fit a categorial model, provided that appropriate methods of data analysis are used. In addition, the questions which are best posed to obtain a succinct classification should be determined. Configu...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00182-p
更新日期：1995-06-01 00:00:00
abstract：:Dupuytren's disease or palmar fibromatosis is a common disabling hand disorder, mainly confined to Caucasians of northwestern European origin. The prevalence of Dupuytren's disease and possible risk factors related to the disease were evaluated in a random sample of 1297 males and 868 females, aged 46 to 74 years. Blo...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(99)00145-6
更新日期：2000-03-01 00:00:00
abstract：:Psychosocial factors influencing smoking cessation were studied in current smokers prior to quitting. Two questionnaires were sent in 1975 and 1981 to adult members of the Finnish Twin Cohort. The 1975 response rate was 89%, and 89% of those eligible replied again in 1981. Analysis was done on data from one twin pair ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(88)90088-1
更新日期：1988-01-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:In 1981, toxic oil syndrome (TOS) appeared in Spain, affecting more than 20,000 persons and causing over 2500 deaths to date. Previous studies have addressed mortality only by gender and age. We analyzed possible prognostic factors in the survival of the cohort. METHODS:The study period was 1 ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(03)00119-7
更新日期：2003-07-01 00:00:00
abstract：:The purpose of this study was to describe patterns of health care use by inner-city patients with asthma and to identify patients at risk for hospitalization. We performed a retrospective cohort study of 1788 patients with asthma aged 5 to 34 years from a large hospital-based multi-specialty practice in inner-city Ind...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(96)00333-2
更新日期：1997-02-01 00:00:00
