[Application of Coefficient for Evaluating Agreement in disordered multi-classification data].

OBJECTIVE: To assess the performance of the Coefficient for Evaluating Agreement (CEA) established based on AC1 coefficient in evaluating the consistency between two raters for disordered multi- classification outcome data in comparison with the Kappa coefficient. METHODS: The diagnostic test data generated by random sampling and Monte Carlo simulation were used for resampling with different parameter combinations (including sample size, proportion of specified events in the population, accidental evaluation rate and number of categories) to compare the mean square error, variance, and variance of the mean of Kappa, AC1 and CEA. The distribution description of CEA was obtained by random sampling for 1000 times from the population. RESULTS: The inconsistency of the incidental evaluation rate caused substantial fluctuation of the mean square error of CEA. Compared with the Kappa coefficient, AC1 and CEA was more stable when the population contained extreme proportions of the specified events. For small samples and inconsistent evaluation rates by chance, the variance and the expectation of variance became obviously expanded for Kappa coefficient and showed smaller changes for CEA. CEA showed nearly a normal distribution for a large sample size. CONCLUSION: Kappa, AC1 and CEA are all the most strongly affected by the accidental evaluation rate, followed then by sample size. For disordered multi-classification outcome data, CEA is more robust against the variations of sample size and accidental evaluation rate.

User-driven prioritization of features for a prospective InterPersonal Health Record: perceptions from the Italian context.

In this paper we present two large user studies in which we gather evidence about the adoption and satisfaction level of users in regard to electronic records that manage health related information from two distinct but complementary perspectives: that of General Practitioners (GPs) about their Electronic Medical Records (EMRs); and that of citizens/patients about their Personal Health Records (PHRs). In these user studies we also probe the user attitudes towards innovative functionalities from these two perspectives and, on the basis of the collected perceptions, we apply an original ranking method to infer what features are valued most and hence could inspire design to make PHRs more situated into the users' lives and drive a higher adoption of these tools. On the basis of the perceived shortcomings of current records, we envision an InterPersonal Health Record (IPHR) that is a sort of hybrid electronic record that merges together typical EMR- and PHR-related features and is endowed with specific functionalities aimed at enhancing interpersonal relationships, communication and collaboration between citizens/patients and their GPs through the record and about its contents. This study is then a contribution in understanding the current attitudes and expectations of potential users towards full-fledged prospective PHRs, as well as a first step in identifying those requirements and priority areas on which to focus further for the design and deployment of more community- and communication-oriented tools in the primary health care domain.

Reporting items of agreement evaluation using Bland-Altman Method:RiBAM / 医学研究生学报

With the promotion and application in medicine and sanitary fields,the reporting quality of Bland-Altman agreement evaluation is worrying.This study aimed at developing a set of reporting standards for Bland-Altman agreement evaluation as the guidance for proper application to improve the reporting quality.A research group was launched to work on reporting standards for Bland-Altman agreement evaluation,and all the requirements for personnel on various levels were made clear.Early in the study,we carried out articles reviews,regular meetings,expert consultations,literary evaluation,item integration and extraction.Then,we invited a multi-disciplinary panel of experts to improve overall design,evaluate reporting items and form the first draft by brainstorming method.Multiple rounds of expert consultations were also conducted with reference to Delphi method to integrate expert advice and form the basic framework of reporting items.Finally,through the thorough analysis and demonstration,we proposed the reporting items for the agreement evaluation of Bland-Altman method (RiBAM) as the recommended report.A list of recommended items called RiBAM was formed,which consisted of 17 first-level items and 23 secondary-level items.RiBAM is more comprehensive and systematic as an important reference for improving the quality of reports by avoiding the omission of reporting contents and achieving the clarity,integrity and transparency of the report.RiBAM recommended items can be a guide for authors in reporting Bland-Altman agreement evaluation as well as a basic reference for journal editors,peer reviewers and readers.