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A variance-based measure of inter-rater agreement in medical databases
Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
Linköping University, Department of Biomedical Engineering, Medical Informatics. Linköping University, The Institute of Technology.
2002 (English)In: Journal of Biomedical Informatics, ISSN 1532-0464, E-ISSN 1532-0480, Vol. 35, no 5-6, 331-342 p.Article in journal (Refereed) Published
Abstract [en]

The increasing use of encoded medical data requires flexible tools for data quality assessment. Existing methods are not always adequate, and this paper proposes a new metric for inter-rater agreement of aggregated diagnostic data. The metric, which is applicable in prospective as well as retrospective coding studies, quantifies the variability in the coding scheme, and the variation can be differentiated in categories and in coders. Five alternative definitions were compared in a set of simulated coding situations and in the context of mortality statistics. Two of them were more effective, and the choice between them must be made according to the situation. The metric is more powerful for larger numbers of coded cases, and Type I errors are frequent when coding situations include different numbers of cases. We also show that it is difficult to interpret the meaning of variation when the structures of the compared coding schemes differ.

Place, publisher, year, edition, pages
2002. Vol. 35, no 5-6, 331-342 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-24560DOI: 10.1016/S1532-0464(03)00036-4Local ID: 6722OAI: oai:DiVA.org:liu-24560DiVA: diva2:244881
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-02-20
In thesis
1. On information quality in primary health care registries
Open this publication in new window or tab >>On information quality in primary health care registries
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Data compilation has a long history in the field of medicine, and domains for which data are pooled include, among others, epidemiological studies and quality assessment. Unfortunately, data may be of low quality with poor validity and reliability, and consequently, decisions based on statistics may be unreliable. The range of applications of information use and reuse is expected to extend from aggregation of information to retrieval of specific cases, which further emphasizes the importance of high quality data. The present thesis deals with aspects of information quality in Swedish primary health care registries. Such information is commonly encoded according to standardized coding systems.

In order to improve coding quality, it is necessary to study the content, structure, and semantics of the coding systems, as well as the functionality of the tools used to access them. In particular, the thesis discusses the effect of the coding system structure - as an instrument for code retrieval as well as data aggregation - on the reliability of coding. In summary, the functionality of a tool that supports coding of medical problems must meet numerous requirements. Flexible structures for browsing the coding system and different types of lexical tools are needed, as are rules for guiding the correct choice of code with respect to a particular medical problem. As an instrument for data compilation, the structure of the coding system may support aggregation in ways that reflect dimension with low variability.

The main contribution of this thesis is to increase understanding of the complexity of disease concepts and the coding systems used for representing them. In addition, it also encompasses the measurements of reliability in coded Swedish primary health care data that were carried out in both a smaller prospective and a larger retrospective study. Further, the thesis proposes a metric for retrospective reliability studies. Finally, the presented coding tool - the Classification Browser - is in itself a platform for further discussion and development in the domain of diagnostic coding.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2003. 65 p.
Series
Linköping Studies in Science and Technology. Dissertations, ISSN 0345-7524 ; 805
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-24499 (URN)6623 (Local ID)91-7373-612-0 (ISBN)6623 (Archive number)6623 (OAI)
Public defence
2003-04-11, Patologsalen, Universitetssjukhuset, Linköping, 09:15 (Swedish)
Opponent
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-02-20

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Petersson, HåkanGill, HansÅhlfeldt, Hans

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