THE SENSITIVITY AND SPECIFICITY OF COMPUTERIZED DATABASES FOR THE DIAGNOSIS OF RHEUMATOID-ARTHRITIS
THE SENSITIVITY AND SPECIFICITY OF COMPUTERIZED DATABASES FOR THE DIAGNOSIS OF RHEUMATOID-ARTHRITIS
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DOI：
10.1002/art.1780370607
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发表时间：
1994-06-01
影响因子：
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通讯作者：
GABRIEL, SE
中科院分区：
文献类型：
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作者：
GABRIEL, SE
客观的。检查计算机医学数据库诊断类风湿性关节炎 (RA) 的准确性。方法。对1987年1月1日所有RA流行病例的完整病历（根据1987年美国风湿病学会诊断标准）进行审查，以确定数据库诊断与病历审查获得的结果相比的敏感性、特异性和预测价值。使用 kappa 统计计算数据库和医疗记录诊断之间的一致性。结果。与基于从完整病历中提取的临床信息的诊断相比，计算机化数据库诊断 RA 的敏感性为 89%，特异性为 74%，阳性预测值为 57%，阴性预测值为 94%。数据库和医疗记录诊断之间的一致性较差（kappa = 0.54）。结论。仅仅依赖此类数据库来诊断 RA 可能会导致严重的误诊。
Objective. To examine the accuracy of a computerized medical database for the diagnosis of rheumatoid arthritis (RA).Methods. The complete medical records of all prevalent cases of RA (according to the 1987 American College of Rheumatology diagnostic criteria) on January 1, 1987 were reviewed to determine the sensitivity, specificity, and predictive value of database diagnoses compared with those obtained by medical record review. Agreement between database and medical record diagnoses was calculated using the kappa statistic.Results. Computerized database diagnoses of RA had a sensitivity of 89%, a specificity of 74%, a positive predictive value of 57%, and a negative predictive value of 94% compared with diagnoses based on clinical information abstracted from the complete medical record. Aereement between database and medical record diagnoses was poor (kappa = 0.54).Conclusion. The sole reliance on such databases for the diagnosis of RA can result in substantial misdiagnosis.