Department of Medicine, Michigan State University, East Lansing, Michigan, USA.
Am J Addict. 2010 Nov-Dec;19(6):523-8. doi: 10.1111/j.1521-0391.2010.00084.x. Epub 2010 Sep 21.
Multidisciplinary experts created a behaviorally defined preliminary criterion standard definition of probable prescription opioid misuse (PPOM) that could be rated from material found in administrative, pharmacy, and electronic health record databases. They then derived a scoring system to identify PPOM patients requiring referral to a specialist. Experts next rated cases of misuse and nonmisuse. Rater no. 1 correctly differentiated 37 of 40 cases (92.5%); kappa coefficient was .79 (CI: .57, 1.00). Rater no. 2 correctly identified 39 of 40 cases (97.5%); kappa was .94 (CI: .81, 1.00). Kappa for comparing raters was .73 (CI: .49, .98). This preliminary study demonstrates that multidisciplinary raters can use behaviorally based criteria to identify patients with known PPOM from health plan databases.
多学科专家制定了一个行为定义的初步标准，用于定义可能的处方阿片类药物滥用（PPOM），可以从行政、药房和电子健康记录数据库中发现的材料进行评定。然后，他们得出了一个评分系统，以确定需要转介给专家的 PPOM 患者。专家们接下来对滥用和非滥用的病例进行了评估。评估员 1 正确区分了 40 例中的 37 例（92.5%）；kappa 系数为.79（置信区间：.57，1.00）。评估员 2 正确识别了 40 例中的 39 例（97.5%）；kappa 系数为.94（置信区间：.81，1.00）。评估员之间的 kappa 系数为.73（置信区间：.49，.98）。这项初步研究表明，多学科评估员可以使用基于行为的标准从健康计划数据库中识别已知的 PPOM 患者。
