Rajmil L, Plasencia A, Borrell C
Institut d'Estudis de la Salut, Generalitat de Catalunya, Servei de Epidemiología, Institut Municipal de la Salut, Ajuntament de Barcelona.
An Esp Pediatr. 1993 Nov;39(5):398-404.
The objective of this study was to verify the reliability of the classifications of perinatal mortality causes. An independent observer coded the cases of perinatal death (n = 152) collected in the Encuesta Confidencial de Mortalidad Perinatal de Barcelona (ECMP, Confidential Perinatal Mortality Inquiry of Barcelona), by using both the Aberdeen classification system (regarding obstetric factors) and the Wigglesworth classification system (according to the initial pathological cause), with the same information used previously by the ECMP Commission. For the Aberdeen classification, the observed concordance index (Po) was 86% and the Kappa coefficient (K) 0.77 (95% CI: 0.68-0.86). For the Wigglesworth classification, the figures were 89% and 0.82 (95% CI: 0.74-0.90), respectively. The disagreement was mainly due to differences in the interpretation of the sequence of death, minimal information available in order to classify the cause of death, and misunderstanding of the existing information. To a lesser extent, the disagreement was caused by a failure to comply with the rules laid down for classifications. The assessment of the causes of death was not significantly influenced by birth weight, gestational age, time of death or the presence of necropsy. These results support the use of classifications of perinatal mortality causes in the context of confidential inquiries.
本研究的目的是验证围产期死亡原因分类的可靠性。一名独立观察者使用阿伯丁分类系统（针对产科因素）和威格尔斯沃思分类系统（根据初始病理原因），对巴塞罗那围产期死亡机密调查（ECMP）收集的围产期死亡病例（n = 152）进行编码，使用的信息与ECMP委员会之前使用的相同。对于阿伯丁分类，观察到的一致性指数（Po）为86%，卡帕系数（K）为0.77（95%置信区间：0.68 - 0.86）。对于威格尔斯沃思分类，相应数字分别为89%和0.82（95%置信区间：0.74 - 0.90）。分歧主要是由于对死亡顺序的解释不同、用于死因分类的可用信息极少以及对现有信息的误解。在较小程度上，分歧是由未遵守分类规定的规则所致。出生体重、孕周、死亡时间或尸检的存在对死因评估没有显著影响。这些结果支持在机密调查中使用围产期死亡原因分类。
