Document Detail

Validation of four clinical indicators of preventable drug-related morbidity.
MedLine Citation:
PMID:  14742787     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Clinical indicators are tools that assess quality issues related to the use of medicines. At this time, validated clinical indicators for preventable drug-related morbidity (PDRM) are lacking. OBJECTIVE: To assess the validity and reliability of using population administrative claims data to identify the extent of PDRM in older adults in Canada. METHODS: Four indicators of PDRM related to cerebrovascular and cardiovascular care were chosen for validation. A random sample of cases that represented the indicators and fit the criteria (hits) for PDRM from the retrospective operationalization of the study database and those that did not fit the criteria (near hits) were selected for chart review. One-page abstracts of the cases were prepared for review by a panel of 5 clinical pharmacists. Validity was assessed by calculating sensitivity, specificity, and positive and negative predictive value. Reliability was assessed using reviewers' agreement scores (kappa statistics). RESULTS: Overall, 119 case abstracts were reviewed by each panelist. The sensitivity ranged from 33% to 100% and the specificity from 51% to 71%. Predictive values ranged from 5.3% to 43% (positive) and 90% to 100% (negative). The overall kappa statistic was fair (0.21). CONCLUSIONS: The validity of the 4 assessed PDRM indicators varied. The reliability was fair; however, these indicators may be useful to screen older adults for PDRM.
Priti S Flanagan; Neil J MacKinnon; Susan K Bowles; Susan A Kirkland
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  38     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-26     Completed Date:  2004-03-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  20-4     Citation Subset:  IM    
Health Outcomes Management, College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada.
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MeSH Terms
Cerebrovascular Disorders / drug therapy,  epidemiology,  prevention & control
Heart Failure / drug therapy,  epidemiology,  prevention & control
Medication Errors / mortality,  prevention & control
Myocardial Infarction / drug therapy,  epidemiology,  prevention & control
Patient Selection
Predictive Value of Tests
Quality Indicators, Health Care*
Risk Factors
Sensitivity and Specificity
Thromboembolism / drug therapy,  epidemiology,  prevention & control
Treatment Failure

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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