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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


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


ICPC-2International Classification of Primary Care



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


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