COMPARISONS OF CAUSE OF DEATH VERIFICATION METHODS AND COSTS IN THE LIPID RESEARCH CLINICS PROGRAM MORTALITY FOLLOW-UP-STUDY
COMPARISONS OF CAUSE OF DEATH VERIFICATION METHODS AND COSTS IN THE LIPID RESEARCH CLINICS PROGRAM MORTALITY FOLLOW-UP-STUDY
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DOI：
10.1016/0197-2456(89)90029-9
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发表时间：
1989-06-01
期刊：
影响因子：
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通讯作者：
PRINEAS, RJ
中科院分区：
文献类型：
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作者：
BANGDIWALA, SI;COHN, R;PRINEAS, RJ
由疾病学家对死因进行分类是标准化的，而且费用相对较低，尽管死亡证明上记录的数据质量受到批评，而且详细程度可能不允许对死亡的具体情况进行审查。一个昂贵的替代方案是由一个医生小组审查额外的临床信息进行分类。与这两种方法的分类所使用的脂质研究诊所计划死亡率随访研究的成本沿着他们的优点和缺点。对于老年人（65岁或以上）的死亡，可能难以确定死亡的根本原因，特别是仅使用死亡证明的心血管疾病死亡原因，并且无法对猝死进行分类。两种分类方法比较了268例老年人死亡和155例非老年男性和女性死亡。 观察者一致性的kappa统计显示中等一致性（k = 0.58），两个年龄组之间无显著差异（p > 0.10）。因此，方法之间的一致性没有受到被分类的死亡年龄的显著影响。然而，一致性图表的检查显示，老年人群中心血管疾病分类的疾病分类偏好。不同分类对高密度脂蛋白胆固醇对冠心病死亡率预测价值分析的影响显示，两种分类方法之间差异不大。
Classification of causes of death by a nosologist is standardized and relatively inexpensive, although the quality of the data recorded on death certificates has been subjected to criticism and the level of detail may not allow examination of specific circumstances of the death. A costly alternative is classification by a panel of physicians reviewing additional clinical information. The costs associated with both methods of classification as utilized by the Lipid Research Clinics Program Mortality Follow-up Study are presented along with their advantages and disadvantages. For deaths among the elderly (65 years or older), determination of the underlying cause of death may be difficult, especially as regards cardiovascular disease causes of death using only the death certificate, and impossible for classifying sudden death. Both classification method are compared for 268 deaths among the elderly and 155 deaths among the nonelderly males and females participating in the study. The kappa statistics for observer agreement indicate moderate agreement (k = 0.58) and were not significantly different between the two age-groups (p > 0.10). Thus, the agreement between the methods was not affected significantly by the age of the deaths being classified. However, examination of the agreement chart showed a preference by the nosological classification for cardiovascular classification in the elderly population. The effect of the different classifications upon the analysis of the predictive value of high-density lipoprotein cholesterol on coronary heart disease mortality showed little difference between both methods of classification.