Clinical validity of a population database definition of remission in patients with major depression
<p>Abstract</p> <p>Background</p> <p>Major depression (MD) is one of the most frequent diagnoses in Primary Care. It is a disabling illness that increases the use of health resources. Aim: To describe the concordance between remission according to clinical assessment an...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2010-02-01
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| Series: | BMC Public Health |
| Online Access: | http://www.biomedcentral.com/1471-2458/10/64 |
| _version_ | 1818385553988517888 |
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| author | Salvatella-Pasant Jordi Gutiérrez-Nicuesa Laura Blanca-Tamayo Milagrosa Sicras-Mainar Antoni Navarro-Artieda Ruth |
| author_facet | Salvatella-Pasant Jordi Gutiérrez-Nicuesa Laura Blanca-Tamayo Milagrosa Sicras-Mainar Antoni Navarro-Artieda Ruth |
| author_sort | Salvatella-Pasant Jordi |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Major depression (MD) is one of the most frequent diagnoses in Primary Care. It is a disabling illness that increases the use of health resources. Aim: To describe the concordance between remission according to clinical assessment and remission obtained from the computerized prescription databases of patients with MD in a Spanish population.</p> <p>Methods</p> <p>Design: multicenter cross-sectional. The population under study was comprised of people from six primary care facilities, who had a MD episode between January 2003 and March 2007. A specialist in psychiatry assessed a random sample of patient histories and determined whether a certain patient was in remission according to clinical criteria (ICPC-2). Regarding the databases, patients were considered in remission when they did not need further prescriptions of AD for at least 6 months after completing treatment for a new episode. Validity indicators (sensitivity [S], specificity [Sp]) and clinical utility (positive and negative probability ratio [PPR] and [NPR]) were calculated. The concordance index was established using Cohen's kappa coefficient. Significance level was p < 0.05.</p> <p>Results</p> <p>133 patient histories were reviewed. The kappa coefficient was 82.8% (confidence intervals [CI] were 95%: 73.1 - 92.6), PPR 9.8% and NPR 0.1%. Allocation discrepancies between both criteria were found in 11 patients. S was 92.5% (CI was 95%: 88.0 - 96.9%) and Sp was 90.6% (CI was 95%: 85.6 - 95.6%), p < 0.001. Reliability analysis: Cronbach's alpha: 90.6% (CI was 95%: 85.6 - 95.6%).</p> <p>Conclusions</p> <p>Results show an acceptable level of concordance between remission obtained from the computerized databases and clinical criteria. The major discrepancies were found in diagnostic accuracy.</p> |
| first_indexed | 2024-12-14T03:40:00Z |
| format | Article |
| id | doaj.art-5f5a7566eb5045ff9b29b4322ece83e9 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-14T03:40:00Z |
| publishDate | 2010-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-5f5a7566eb5045ff9b29b4322ece83e92022-12-21T23:18:30ZengBMCBMC Public Health1471-24582010-02-011016410.1186/1471-2458-10-64Clinical validity of a population database definition of remission in patients with major depressionSalvatella-Pasant JordiGutiérrez-Nicuesa LauraBlanca-Tamayo MilagrosaSicras-Mainar AntoniNavarro-Artieda Ruth<p>Abstract</p> <p>Background</p> <p>Major depression (MD) is one of the most frequent diagnoses in Primary Care. It is a disabling illness that increases the use of health resources. Aim: To describe the concordance between remission according to clinical assessment and remission obtained from the computerized prescription databases of patients with MD in a Spanish population.</p> <p>Methods</p> <p>Design: multicenter cross-sectional. The population under study was comprised of people from six primary care facilities, who had a MD episode between January 2003 and March 2007. A specialist in psychiatry assessed a random sample of patient histories and determined whether a certain patient was in remission according to clinical criteria (ICPC-2). Regarding the databases, patients were considered in remission when they did not need further prescriptions of AD for at least 6 months after completing treatment for a new episode. Validity indicators (sensitivity [S], specificity [Sp]) and clinical utility (positive and negative probability ratio [PPR] and [NPR]) were calculated. The concordance index was established using Cohen's kappa coefficient. Significance level was p < 0.05.</p> <p>Results</p> <p>133 patient histories were reviewed. The kappa coefficient was 82.8% (confidence intervals [CI] were 95%: 73.1 - 92.6), PPR 9.8% and NPR 0.1%. Allocation discrepancies between both criteria were found in 11 patients. S was 92.5% (CI was 95%: 88.0 - 96.9%) and Sp was 90.6% (CI was 95%: 85.6 - 95.6%), p < 0.001. Reliability analysis: Cronbach's alpha: 90.6% (CI was 95%: 85.6 - 95.6%).</p> <p>Conclusions</p> <p>Results show an acceptable level of concordance between remission obtained from the computerized databases and clinical criteria. The major discrepancies were found in diagnostic accuracy.</p>http://www.biomedcentral.com/1471-2458/10/64 |
| spellingShingle | Salvatella-Pasant Jordi Gutiérrez-Nicuesa Laura Blanca-Tamayo Milagrosa Sicras-Mainar Antoni Navarro-Artieda Ruth Clinical validity of a population database definition of remission in patients with major depression BMC Public Health |
| title | Clinical validity of a population database definition of remission in patients with major depression |
| title_full | Clinical validity of a population database definition of remission in patients with major depression |
| title_fullStr | Clinical validity of a population database definition of remission in patients with major depression |
| title_full_unstemmed | Clinical validity of a population database definition of remission in patients with major depression |
| title_short | Clinical validity of a population database definition of remission in patients with major depression |
| title_sort | clinical validity of a population database definition of remission in patients with major depression |
| url | http://www.biomedcentral.com/1471-2458/10/64 |
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