THE ROLE OF DIAGNOSTIC INCONSISTENCY IN CHANGING RATES OF OCCURRENCE FOR CORONARY HEART-DISEASE
THE ROLE OF DIAGNOSTIC INCONSISTENCY IN CHANGING RATES OF OCCURRENCE FOR CORONARY HEART-DISEASE
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DOI：
10.1016/0895-4356(92)90109-z
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发表时间：
1992-09-01
影响因子：
7.2
通讯作者：
FEINSTEIN, AR
中科院分区：
文献类型：
--
作者：
BURNAND, B;FEINSTEIN, AR
对1965年、1975年和1985年在一所大学医院的尸检中冠心病(CHD)的死前(活体)和死后诊断进行了比较。长期趋势显示，在死亡前诊断中，真阳性和假阴性的比例逐渐上升。这两种诊断错误的变化都将逐渐降低官方生命统计中计算的冠心病数量。经过适当的统计校正，康涅狄格州的冠心病发生率变得更高，并显示出不那么戏剧性的长期下降趋势。结果表明，在以表面价值接受生命统计数据并进行分析以对变化的数字进行生物学解释之前，需要在准确性方面进行重大改进。
The ante-mortem (in vivo) and post-mortem diagnoses of coronary heart disease (CHD) were compared in necropsies at a university hospital for 1965, 1975, and 1985. The secular trends showed gradually rising proportions in both true positive and false negative ante-mortem diagnoses. Both types of change in diagnostic error would progressively lower the counted numbers of CHD in official vital statistics. With suitable statistical corrections, the occurrence rates of CHD in Connecticut became much higher and showed less dramatic trends in secular decline. The results indicate that major improvements in accuracy are needed before vital statistics data are accepted at face value and analyzed for biologic explanations of the changing numbers.