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BMC Public Health

, 10:64

First Online: 11 February 2010Received: 07 July 2009Accepted: 11 February 2010DOI: 10.1186-1471-2458-10-64

Cite this article as: Sicras-Mainar, A., Blanca-Tamayo, M., Gutiérrez-Nicuesa, L. et al. BMC Public Health 2010 10: 64. doi:10.1186-1471-2458-10-64

Abstract

BackgroundMajor depression MD is one of the most frequent diagnoses in Primary Care. It is a disabling illness that increases the use of health resources. Aim: To describe the concordance between remission according to clinical assessment and remission obtained from the computerized prescription databases of patients with MD in a Spanish population.

MethodsDesign: multicenter cross-sectional. The population under study was comprised of people from six primary care facilities, who had a MD episode between January 2003 and March 2007. A specialist in psychiatry assessed a random sample of patient histories and determined whether a certain patient was in remission according to clinical criteria ICPC-2. Regarding the databases, patients were considered in remission when they did not need further prescriptions of AD for at least 6 months after completing treatment for a new episode. Validity indicators sensitivity S, specificity Sp and clinical utility positive and negative probability ratio PPR and NPR were calculated. The concordance index was established using Cohen-s kappa coefficient. Significance level was p < 0.05.

Results133 patient histories were reviewed. The kappa coefficient was 82.8% confidence intervals CI were 95%: 73.1 - 92.6, PPR 9.8% and NPR 0.1%. Allocation discrepancies between both criteria were found in 11 patients. S was 92.5% CI was 95%: 88.0 - 96.9% and Sp was 90.6% CI was 95%: 85.6 - 95.6%, p < 0.001. Reliability analysis: Cronbach-s alpha: 90.6% CI was 95%: 85.6 - 95.6%.

ConclusionsResults show an acceptable level of concordance between remission obtained from the computerized databases and clinical criteria. The major discrepancies were found in diagnostic accuracy.

AbbreviationsMDMajor Depression

PCPrimary Care

ADAntidepressants

ICPC-2International Classification of Primary Care

SSensitivity

SpSpecificity

PPVPredictive Positive Value

NPVNegative Predictive Value

PPRPositive Probability Ratio

NPRNegative Probability Ratio.

Milagrosa Blanca-Tamayo, Laura Gutiérrez-Nicuesa, Jordi Salvatella-Pasant and Ruth Navarro-Artieda contributed equally to this work.

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Autor: Antoni Sicras-Mainar - Milagrosa Blanca-Tamayo - Laura Gutiérrez-Nicuesa - Jordi Salvatella-Pasant - Ruth Navarro-Artieda

Fuente: https://link.springer.com/







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