Abstract:
OBJECTIVES:Emergency department triage systems can be considered prediction rules with an ordinal outcome, where different directions of misclassification have different clinical consequences. We evaluated strategies to compare the performance of triage systems and aimed to propose a set of performance measures that should be used in future studies. STUDY DESIGN AND SETTING:We identified performance measures based on literature review and expert knowledge. Their properties are illustrated in a case study evaluating two triage modifications in a cohort of 14,485 pediatric emergency department visits. Strengths and weaknesses of the performance measures were systematically appraised. RESULTS:Commonly reported performance measures are measures of statistical association (34/60 studies) and diagnostic accuracy (17/60 studies). The case study illustrates that none of the performance measures fulfills all criteria for triage evaluation. Decision curves are the performance measures with the most attractive features but require dichotomization. In addition, paired diagnostic accuracy measures can be recommended for dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R2 for ordinal analyses. Other performance measures provide limited additional information. CONCLUSION:When comparing modifications of triage systems, decision curves and diagnostic accuracy measures should be used in a dichotomized analysis, and the triage-weighted kappa and Nagelkerke's R2 in an ordinal approach.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Zachariasse JM,Nieboer D,Oostenbrink R,Moll HA,Steyerberg EWdoi
10.1016/j.jclinepi.2017.11.004subject
Has Abstractpub_date
2018-02-01 00:00:00pages
27-34eissn
0895-4356issn
1878-5921pii
S0895-4356(17)30257-3journal_volume
94pub_type
杂志文章abstract:INTRODUCTION:Weight loss interventions often present small mean weight changes over time, despite the fact that a substantial proportion of the participants lost more weight. This effect is often leveled out by the substantial proportion of participants who gained weight during the trial. The aim of this study is to id...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2014.03.007
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVES:In a twinning partnership between the Canadian Society for International Health and Kazakhstan's Ministry of Health, a project to build capacity and a process for the adaptation and implementation of international clinical practice guidelines (CPGs) was undertaken. STUDY DESIGN AND SETTING:A pragmatic CPG a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2015.05.001
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea. STUDY DESIGN AND SETTING:Cost-effectiveness analysis among patients consulting the emergency room of a government institution. METHOD:Cost of treatment and outcome of part...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jclinepi.2006.08.004
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:Timely and comprehensive reporting of clinical trial results builds the backbone of evidence-based medicine and responsible research. The proportion of timely disseminated trial results can inform alternative national and international benchmarking of university medical centers (UMCs). STUDY DESIGN AND SETT...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.06.002
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:To assess if predefined variables in study design, instrument type, and patient characteristics account for variance in reported retest reliability for the Oswestry Disability Index (ODI) and Roland-Morris Questionnaire (RMQ). A second aim was a more precise estimate of instrument reliability. STUDY DESIGN A...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jclinepi.2012.06.024
更新日期:2013-03-01 00:00:00
abstract::Although developed societies have undergone many profound changes during recent decades, including urbanization, increased traffic and aging of the populations, epidemiologic information on secular trends in profiles of injuries is limited. We investigated such trends in Finland by selecting from the National Hospital...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00346-2
更新日期:2001-06-01 00:00:00
abstract::Results from pragmatic trials should reflect the comparative treatment effects encountered in patients in real-life clinical practice to guide treatment decisions. Therefore, pragmatic trials should focus on outcomes that are relevant to patients, clinical practice, and treatment choices. This sixth article in the ser...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2016.12.022
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Chronic kidney disease (CKD) is a global health concern that is increasing mainly as the result of increasing incidences of diabetes and hypertension. Furthermore, if left untreated, individuals with CKD may progress to end-stage kidney failure. Identifying individuals with undiagnosed CKD or those who are a...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2012.06.020
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:Citations by other researchers are important in the dissemination of research findings. We aimed to investigate whether preferential citation of statistically significant articles exists in the psychiatric literature. STUDY DESIGN AND SETTINGS:We analyzed all original research papers published in 1996 in fou...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.11.014
更新日期:2007-09-01 00:00:00
abstract::Intraindividual variability (IIV) in total cholesterol levels based on measurements taken 1 week apart is compared with an estimate based on measurements taken 2 years apart. Single-subject 95% confidence intervals around the mean of two repeated measurements were Xi +/- 21 and +/- 28 mg/dl, respectively, and Xi +/- 3...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(93)90115-h
更新日期:1993-10-01 00:00:00
abstract::Quality of life and functional health were measured cross-sectionally for 314 adult ambulatory primary care patients in a rural clinic and found to be much better for patients with low severity of illness who required no confinement to home because of health problems, than for patients with high severity of illness wh...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/0895-4356(92)90171-i
更新日期:1992-11-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(02)00455-9
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To assess agreement between parents' proxy reports of children's respiratory-related health service use and administrative data. STUDY DESIGN AND SETTING:A retrospective analysis of statistical agreement between clinical and claims data for reports of physician visits, emergency department (ED) visits, and h...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2007.02.002
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVES:To investigate cost savings from and implications of replacing the single risk with a total cardiovascular risk approach in primary prevention of cardiovascular disease (CVD). STUDY DESIGN AND SETTING:A cost analysis using data from the 2007-08 Jamaica Health and Lifestyle Survey of 1,432 persons aged 40 ye...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2014.11.027
更新日期:2015-09-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.06.008
更新日期:2011-05-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/0895-4356(92)90093-3
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To assess whether nominally statistically significant effects in meta-analyses of clinical trials are true and whether their magnitude is inflated. STUDY DESIGN AND SETTING:Data from the Cochrane Database of Systematic Reviews 2005 (issue 4) and 2010 (issue 1) were used. We considered meta-analyses with bina...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.12.012
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To compare and contrast clinical epidemiology and population health perspectives on the role of health care in reducing socioeconomic disparities in health. STUDY DESIGN AND SETTING:A review of concepts outlined in selected articles on population health and clinical epidemiology and a systematic literature s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2004.10.020
更新日期:2005-08-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2019.11.009
更新日期:2020-03-01 00:00:00
abstract::The history of the application of statistical theory to the analysis of clinical trials is reviewed. The current orthodoxy is a somewhat illogical hybrid of the original theory of significance tests of Edgeworth, Karl Pearson, and Fisher, and the subsequent decision theory approach of Neyman, Egon Pearson, and Wald. T...
journal_title:Journal of clinical epidemiology
pub_type: 历史文章,杂志文章
doi:10.1016/s0895-4356(99)00156-0
更新日期:2000-03-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2004.08.009
更新日期:2005-04-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.06.016
更新日期:2019-11-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章,评审
doi:10.1016/j.jclinepi.2010.09.013
更新日期:2011-07-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/0895-4356(95)00054-2
更新日期:1995-11-01 00:00:00
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journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2006.01.004
更新日期:2006-08-01 00:00:00
abstract::To compare Charlson indices based on chart data and ICD-9 data for agreement overall and on rating specific comorbid conditions, and to compare mortality risks associated with these indices. Prospective cohort study. Six general medicine wards at Yale-New Haven Hospital. 524 consecutive patients who had no clinical ev...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(00)00367-x
更新日期:2001-07-01 00:00:00
abstract::This article reports on the development and validation of the Italian SF-36 Health Survey using data from seven studies in which an Italian version of the SF-36 was administered to more than 7000 subjects between 1991 and 1995. Empirical findings from a wide array of studies and diseases indicate that the performance ...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(98)00094-8
更新日期:1998-11-01 00:00:00
abstract::Time to revision is an important criterion describing the quality of implants in total joint surgery. Estimates of failure probabilities are required to inform a patient about the risk of suffering a reoperation. Also, regression models are used for comparing different prosthesis designs. Typically, patients dying bef...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/s0895-4356(01)00371-7
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:Meta-analyses inform clinical practice by summarizing treatment effect estimates based on results from several trials. However, the statistical significance of a meta-analysis (i.e., whether the pooled treatment effect is statistically significant or not) may rely on the outcome of only a few patients from s...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2019.03.012
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Estimates of minimal clinically important improvements (MCIIs) are larger among patients with higher values at baseline, suggesting that these patients require larger changes to appreciate improvements. We examined if baseline dependency of MCIIs was associated with specific patients across three measures, or...
journal_title:Journal of clinical epidemiology
pub_type: 杂志文章
doi:10.1016/j.jclinepi.2013.10.025
更新日期:2014-06-01 00:00:00