The improving accuracy of the basic data and the exposed-to-risk of the English life tables.
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Demography↗
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Effect of proxy-reported smoking status on population estimates of smoking prevalence.
The use of proxy respondents in surveys designed to provide population estimates of smoking prevalence offers an inexpensive way to obtain these data. The accuracy of this information is examined in analyzing data from tobacco use surveys of adults conducted in 22 North American communities as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation. Proxy-reported smoking status was obtained in a cross-sectional telephone survey conducted from August 1993 to January 1994 (n = 99,682). Self-reported smoking status was obtained from an in-depth interview of a sample of the respondents aged 25-64 years enumerated from the telephone survey (n = 31,417). Discrepancy rates were calculated by comparing the proxy-reported and self-reported smoking statuses of a given individual (n = 10,226). In both surveys, respondents were categorized as current smokers (those who currently smoke and have smoked at least 100 cigarettes in their lifetime), recent quitters (< or = 8 years since cessation), long-term quitters (> 8 years since cessation), and never smokers. The overall discrepancy rate between the self-report and the proxy report was 5.4%. Self-respondents who were black, Hispanic, Asian, recent quitters, or aged 25-34 years were more likely to have inconsistent proxy reports. The authors estimate that the screener interview underestimated the true smoking prevalence by 0.1% when they corrected for smoking status discrepancies. These results confirm that proxy-reported smoking status is an accurate and effective means to monitor populationwide smoking prevalence of adults.
Adult↗
Reporting errors in time-to-pregnancy data collected with a short questionnaire. Impact on power and estimation of fecundability ratios.
Few tools exist in reproductive epidemiology for studying adverse effects on fertility. Data on time to pregnancy (the number of menstrual cycles required to conceive) can be used to estimate fecundability ratios, a sensitive endpoint for identifying factors associated with reduced fertility. Time-to-pregnancy data can be collected in detailed interviews. The accuracy of data collected on brief, self-administered questionnaires is not known. In a study of occupational exposures to dental assistants conducted in 1987-1988, 523 women provided time-to-pregnancy data both on a short, mailed questionnaire and in a detailed telephone interview. The correlation between the two measures was 0.82. Assuming that the detailed data were accurate, reporting errors in data from the short form were distributed nondifferentially with respect to most covariates of interest in fecundability analyses. Simulation studies were conducted to estimate bias and loss of power from the misclassification. Bias was toward the null. Substantial power was lost in detecting weak exposures. However, exposures that reduce fecundability by 50 percent (equivalent to adding about three cycles to the median time to pregnancy) could still be detected with 80 percent power in samples of about 100 women (half of them exposed to a possible toxin). The authors conclude that time-to-pregnancy data collected with a few self-administered questions can be useful in a variety of epidemiologic studies, including occupational and environmental surveillance programs.
Bias↗
Accuracy of Medicare claims data for estimation of cancer incidence and resection rates among elderly Americans.
To explore the reliability of Medicare Part A claims data for clinical and health services research related to the care of patients with cancer, the authors compared estimates of the incidence of and resection rates for cancer of the breast, colon, and lung derived from analysis of Medicare Part A data versus data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Incidence rates of breast, colon, and lung cancer estimated from Medicare Part A data were within 6% of estimates derived from SEER data. Resection rates estimated from Medicare Part A data, in contrast, were 12% to 27% lower than resection rates based on SEER data. This discrepancy is not explained by variations in practice between regions participating in versus those not participating in the SEER registries but may be due to undercoding of surgical procedures in Medicare Part A data. This analysis suggests that Medicare data can provide useful insights into the care of patients with cancer, but research regarding inpatient procedures employed in management of cancer should be based on analysis of Medicare Parts A and B data combined.
Abstracting and Indexing↗
Data quality--monitoring the accuracy of clinical information.
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Abstracting and Indexing↗
Measuring the accuracy of vital status data in cohort studies.
To measure the quality of vital status data in a retrospective cohort study of mortality among former servicemen of the Vietnam Conflict era, test subjects of independently determined vital status were included among study subjects during vital status ascertainment procedures. This allowed for differentiation between vital status "unknown" and incorrect assignment of vital status, and enabled measurement of the quality of both live and deceased vital status data. Four parameters based on sensitivity and specificity were used to express the quality of vital status data. The deceased specificity rate was 100 per cent, the deceased sensitivity rate was 95.7 per cent, the live specificity rate was 98.5 per cent, and the live sensitivity rate was 95.4 per cent. Using models of misclassification, the estimated death rate was found to be most sensitive to changes in the deceased specificity rate, indicating that emphasis should be given to minimizing incorrect ascertainment of truly alive subjects as deceased when developing vital status ascertainment procedures.
Adult↗
General radiologists' diagnostic accuracy: incomplete presentation of data casts doubt on study's conclusions.
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Bias↗
Accuracy of pharmaceutical tracking data with regard to optometrists' prescribing.
BACKGROUND: The optometric scope of practice has increased dramatically over the last 30 years. This includes the ability to administer legend drugs to facilitate the examination process and prescribe legend drugs to treat the eye and adjacent areas in accordance with state laws. However, because such laws are relatively new in some states, the prescribing optometric communities in the United States may have difficulty in making their presence known amongst the pharmaceutical tracking companies. This study looked at the relationship between prescriptions written and pharmaceutical tracking company outcomes. METHOD: Optometrists were recruited from five states--Florida, Illinois, Missouri, North Carolina, and Texas--to participate in this study. They represented urban and rural practices, group and solo practices, and multidisciplinary practices. They were requested to track all prescriptions they wrote for legend pharmaceutical drugs during the months of August, September, and October 2000, as well as the number of refills authorized. Numbers were obtained from a pharmaceutical tracking company for the same optometrists for the period July to September 2000, and October to December 2000. The results reported by the optometrists were compared to the results provided by the pharmaceutical tracking company. RESULTS: There was a significant difference between the numbers reported as outcomes by the pharmaceutical tracking company and the self-reported prescriptions written. DISCUSSION: The current system for crediting prescriptions to optometrists seems to have some shortcomings. All parties involved must work to ensure that optometrists are being properly credited for the pharmaceutical prescriptions they write. Possible steps that may be taken by individuals, the optometric profession, and the pharmaceutical industry are discussed.
Drug Prescriptions↗
[Control of accuracy of immunoserological laboratory data on medical network and standardization].
Construction of a medical network for each region and organization has become possible by utilization of information technology. Standardization of the data on the medical network is urgent. Especially, the standardization of immunoserological data is much delayed. In this study, the possibility of standardization of such data was reconsidered based on the findings from various control surveys. Regarding the measurement items for serum concentrations of proteins and other compounds, we concluded that standardization should occur in a manner similar to the method for standardization of biochemical data and accurate control. The data on CRP, IgG, IgA, IgM and AFP, which are determined using the respective standard compound, were converged to a range with inter-facility differences of less than 10% CV. The data on CEA were also converged to achieve an inter-facility difference of less than 10% CV through repeated survey. Automatic measurement for the markers of infection diseases has progressed, and the expression of measurements was changed to the absolute value of COI, U/ml or IU/ml although it was titer in the past. Since these expressions now coexist, it is impossible to standardize the data with absolute qualitative values. It seemed necessary to present them uniformly with qualitative or clinical criteria values or express the presence or absence of infection by a combination of related markers. The measurements obtained from autoantibody-related tests using identical reagent were found coincident, but measurements obtained using different reagents were discrepant and the differences were greater than the sensitivity of measurement. In immunoserological testing and immunochemical testing, it is most important whether the antigen/antibody used as the reagent is the same preparation or not. Therefore, the test should be reconsidered through setting a certain restrictions on each recognition site of epitope and antibody. Thus, we concluded that use of a suitable standard substance is effective for standardization of immunological data.
Biomarkers↗
[Accuracy of participation rate data for health examination research].
Each local government conducts health examinations based on the Health and Medical Law for the Aged. However, since some residents are able to take health examinations at their own work places, for example, and the local government are allowed to exclude such people from taking the law-mandated health examination, it is difficult to obtain an accurate picture of the examination rate in each area. We investigated the actual participation status for health examination services of all of the 6,080 persons 20 years and over in age in Sakuragawa-mura, Ibaraki Prefecture. A comparative investigation was made on 3,655 non-bedridden/non-hospitalized persons of 40 years and over to ascertain the reliability of responses to questions about participation in lung cancer and gastric cancer examination services given by the village. The rate of valid responses was extremely low in those who had not participated in health examinations (male 54%, female 55% for the lung cancer, and male 53%, female 56% for the gastric cancer). These discrepancies are assumed to be the result of confusing the current health examinations with: (1) the health examination given in the previous year, (2) other kinds of health examinations, or (3) the health examination given in the work place or the like. A comparative investigation through logistic regression analysis, between the responses to the questions in this investigation and the actual health examination participation records, for persons who had not yet taken either lung cancer examinations or gastric cancer examinations (908 males and 938 females for the former, and 1,038 males and 1,187 females for the latter). Results showed that the influence of (1) and (2) were more or less detected in every kind of cancer examination, and the influence of (1) on the gastric cancer examination was particularly clear. No definite result was obtained about (3), because the actual record of the health examination service at the work place, etc. was unavailable. The results of this study suggests the necessity of a careful examination of methods when conducting a comprehensive service investigation for the health examinations.
Female↗
Congenital cystic adenomatoid malformation: accuracy of prenatal diagnosis, prevalence and outcome in a general population.
OBJECTIVES: Most available data regarding accuracy of prenatal diagnosis, prevalence and outcome of congenital cystic adenomatoid malformation (CCAM) are derived largely from tertiary referral centres and may not reflect general population rates. We aimed to describe the accuracy of prenatal diagnosis, ascertain the population prevalence and post-natal outcome for cases of suspected CCAM. METHODS: Retrospective collection of prenatal and paediatric data for cases of suspected CCAM notified to the Trent Congenital Anomalies Register 1997 to 2001. RESULTS: Thirty-seven cases of CCAM were suspected prenatally. Twenty-one cases were confirmed post-natally as having a CCAM (positive predictive value 57%). Eighteen of the 21 cases were delivered at term as live births, 15 of which have undergone successful surgery to date. Thirteen of the 37 cases had apparently resolved by delivery. Three further cases were subsequently found to be cases of lung sequestration or lobar emphysema. Five cases of CCAM were detected after delivery (sensitivity of prenatal detection 81%). The population prevalence at delivery was 9.0 per 1,00,000 total births. Five confirmed cases of CCAM developed hydrops, three required in utero intervention and delivered as live births at term, one was terminated and one died in utero. The overall mortality in the confirmed cases of CCAM was 23% of which the majority were terminations of pregnancy. CONCLUSIONS: Problems of diagnostic accuracy and apparent resolution of CCAM render counselling difficult, although our data suggest that the prognosis is better than others have reported. Confirmation of the diagnosis in the neonatal period is vital in order to obtain the true population prevalence figures and to interpret outcome data.
Adult↗
Accuracy and time requirements of a bar-code inventory system for controlled substances.
The effect of a bar-code system on personnel time requirements and data-entry accuracy in an existing automated controlled substances inventory system was determined. In the previous system, technicians used a keyboard and alphanumeric codes to enter into the computer data about the physical transfer of controlled substances among hospital areas. A system for barcode data entry was adapted for use with the existing procedure. After learning to use the bar-code system, four experienced technicians entered data by the keyboard method for eight days and the bar-code method for eight days during a 32-day study period. The amount of time required to enter all transactions and the accuracy of data entry were measured. Mean data-entry times for the keyboard and bar-code methods were not significantly different, most likely because of the greater number of manipulations needed for bar-code data entry. The mean percentage error associated with the bar-code method (0.79%) was significantly less than the error associated with the keyboard method (1.53%). For this particular computer system in which bar-code data entry was adapted to existing procedures, use of bar codes to enter controlled substances inventory data was not substantially faster but was more accurate than a traditional key-board data-entry method.
Drug and Narcotic Control↗
Base-calling of automated sequencer traces using phred. II. Error probabilities.
Elimination of the data processing bottleneck in high-throughput sequencing will require both improved accuracy of data processing software and reliable measures of that accuracy. We have developed and implemented in our base-calling program phred the ability to estimate a probability of error for each base-call, as a function of certain parameters computed from the trace data. These error probabilities are shown here to be valid (correspond to actual error rates) and to have high power to discriminate correct base-calls from incorrect ones, for read data collected under several different chemistries and electrophoretic conditions. They play a critical role in our assembly program phrap and our finishing program consed.
Base Sequence↗
An experimental system for comparing speed, accuracy, and completeness of physician data entry using electronic and paper methods.
Electronic medical record (EMR) systems have important potential advantages over traditional paper-based systems, but they require that physicians assume responsibility for data entry. However, little is known about the quality of physician data entry in electronic systems. This study describes a system for comparing the speed, accuracy, and completeness of examination data entry using electronic and paper methods. Data will be shown to demonstrate that this may be a simple, reproducible, and useful technique.
Humans↗
Tachistoscopic presentation of verbal stimuli for assessing cerebral dominance: reliability data and some practical recommendations.
Reliability data point to rather high test-retest correlations (greater than or equal to 0.65) for VHF data with four- and five-letter words as stimuli, but replicate previous findings that the first test score correlates poorly with later test scores. The same results are obtained for accuracy and latency data, though small differences exist. All laterality indices lead to the same conclusions and have high intercorrelations. The point-biserial correlation coefficient is, however, a slightly more reliable index of naming latency than the mere difference between LVF and RVF. No such superiority is found for the indices based on accuracy data. The results also point to the need to present a sufficient number of stimuli before firm conclusions can be drawn.
Adult↗
Completeness of data entry in three cancer surgery databases.
AIMS: Clinical databases are regularly used for audit and research purposes. The accuracy of data input is critical to the value of these tools, but little is known about the factors which influence the completeness of data recording. The aim of this study was to evaluate the influences affecting completeness of data recording in computerized clinical databases of cancer treatment. METHODS: Data omission rates in three databases dealing with management of breast, colorectal and gastro-oesophageal cancers were calculated. The effects of (a) type of record; (b) nature of data and (c) training required to interpret data were evaluated by univariate and multivariate analyses. RESULTS: The overall data omission rate was 21.9% (upper GI 27.6%, breast 19.6%, colorectal 32.7%, P=0.13). For different categories of data, omission rates varied from 0% to 55%. Fields requiring a 'text field' or 'numerical' entry, or containing demographic data, data required for the process of care or data which required no interpretation were associated with low omission rates. Clinical data, and fields requiring a 'yes/no' response were associated with high omission rates (45 and 48% respectively). Clinical data and data relating to patient demographic details were independently associated with high and low omission rates respectively (odds ratios for significant missing data 86.9 and 1 respectively). CONCLUSION: Clinical data are poorly captured by current cancer surgery databases. Reasons for the poor completion of fields requiring input by clinical staff, particularly availability of time and training, and prioritization of work, should be addressed. Re-design of databases to ensure that data entry is simple and unambiguous may improve accuracy.
Breast Neoplasms↗
Large scale analysis of MASCOT results using a Mass Accuracy-based THreshold (MATH) effectively improves data interpretation.
In this report, we take a heuristic approach to studying the effects of mass tolerance settings and database size on the sensitivity and specificity of MASCOT. We also examine the efficacy of the MASCOT Identity Threshold as a discriminator when applied to QqTOF data with an average mass accuracy of 10 ppm or better. As predicted, arbitrarily large mass tolerance settings negatively affect MASCOT's specificity, and to a lesser degree, sensitivity. Increased mass tolerances also render the generation of a significance threshold less effective. To study these effects, we used Bayes' Law to calculate MASCOT's predictive values. With a relatively small search database (Human IPI), MASCOT had a mean positive predictive value of 0.993 when combined with MASCOT's Identity Threshold. However, the corresponding average negative predictive value, or the probability that an ion was not present given no score or a score below threshold, was reduced as mass tolerances were tightened, and had an average value of 0.717. This value was improved upon by extrapolating an empirical threshold using a reversed database search and a new algorithm to rapidly identify false positive identifications. Using the empirical threshold reduced false negative identifications on the average 17% while limiting the false positive rate to below 5%; even larger reductions were obtained using mass tolerances approaching two times the actual error of the experimental data. A simple application of this strategy to the analysis of a microdissected glioblastoma multiforme sample analyzed by IEF/LC-MS/MS is reported, as is a description of the tools required to implement a large scale analysis using this alternative approach.
Algorithms↗
Availability and accuracy of cancer and smoking data obtained from next of kin for decedents in a retrospective cohort study.
We report on the availability and accuracy of next-of-kin data on 372 decedents gathered in the conduct of a retrospective cancer incidence study. Two mailed questionnaires were followed by phone calls for nonrespondents. The overall response rate for the next of kin of decedents was 59%, markedly less than the 79% response rate for living cohort members. Validity of data provided by next of kin regarding cancer incidence and smoking habits of the decedents was assessed via a comparison with medical records, which were considered accurate for the purposes of this comparison. For the 117 men for whom we had both types of records, next of kin were generally able to report accurately both whether the decedent ever had cancer (91% agreement) and the cancer type (84% agreement). Next-of-kin data generally agreed with medical record data for number of years smoked or for number of years since quitting, whereas next of kin underreported the amount smoked by decedents. The difficulty in contacting next of kin and their frequent inability to provide detailed and accurate information on smoking may make it difficult to adjust for confounding by smoking in nested case-control studies.
Epidemiologic Methods↗