Validation and validity of diagnoses in the General Practice Research Database: a systematic review
Validation and validity of diagnoses in the General Practice Research Database: a systematic review
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DOI：
10.1111/j.1365-2125.2009.03537.x
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发表时间：
2010-01-01
影响因子：
3.4
通讯作者：
Hall, Andrew J.
中科院分区：
文献类型：
--
作者：
Herrett, Emily;Thomas, Sara L.;Hall, Andrew J.
目的调查全科医学研究数据库（GPRD）中用于验证诊断的方法范围，总结结果并评估这些验证的质量。方法采用PubMed和Embase检索1987年至2008年4月间发表的GPRD数据，进行系统文献综述。从会议记录、有关期刊的过期刊、检索出版物的书目和有关网站中确定了其他出版物。报告试图验证GPRD中记录的疾病诊断的出版物也包括在内。结果我们确定了212篇出版物，通常证实了不止一种诊断。总共有357项验证调查了183种不同的诊断符合我们的纳入标准。其中，303个（85%）利用GPRD以外的数据来验证诊断。其余部分仅使用数据库中记录的数据。确诊病例的中位比例为89%（范围24-100%）。验证方法和结果的细节往往不完整。结论本研究采用了多种有效度评估方法。总体而言，效度估计较高。然而，证实报告的质量往往不足以作出明确的解释。并非所有方法都提供有效性的定量估计，大多数方法只考虑一组高度选定的病例中诊断代码的阳性预测值。我们就方法和报告提出建议，以进一步加强在研究中使用GPRD。
AIMSTo investigate the range of methods used to validate diagnoses in the General Practice Research Database (GPRD), to summarize findings and to assess the quality of these validations.METHODSA systematic literature review was performed by searching PubMed and Embase for publications using GPRD data published between 1987 and April 2008. Additional publications were identified from conference proceedings, back issues of relevant journals, bibliographies of retrieved publications and relevant websites. Publications that reported attempts to validate disease diagnoses recorded in the GPRD were included.RESULTSWe identified 212 publications, often validating more than one diagnosis. In total, 357 validations investigating 183 different diagnoses met our inclusion criteria. Of these, 303 (85%) utilized data from outside the GPRD to validate diagnoses. The remainder utilized only data recorded in the database. The median proportion of cases with a confirmed diagnosis was 89% (range 24-100%). Details of validation methods and results were often incomplete.CONCLUSIONSA number of methods have been used to assess validity. Overall, estimates of validity were high. However, the quality of reporting of the validations was often inadequate to permit a clear interpretation. Not all methods provided a quantitative estimate of validity and most methods considered only the positive predictive value of a set of diagnostic codes in a highly selected group of cases. We make recommendations for methodology and reporting to strengthen further the use of the GPRD in research.