Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease

Erik Kjoller; Jørgen Hilden; Per Winkel; Niels J Frandsen; Søren Galatius; Gorm Jensen; Jens Kastrup; Jorgen Fischer Hansen; Hans Jørn Jepsen Kolmos; Christian M Jespersen; Per Hildebrandt; Christian Nyfeldt Gluud; CLARICOR Trial Group

doi:10.1016/j.jclinepi.2011.09.011

Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease

Erik Kjoller, Jørgen Hilden, Per Winkel, Niels J Frandsen, Søren Galatius, Gorm Jensen, Jens Kastrup, Jorgen Fischer Hansen, Hans Jørn Jepsen Kolmos, Christian M Jespersen, Per Hildebrandt, Christian Nyfeldt Gluud, CLARICOR Trial Group

11 Citations (Scopus)

Abstract

Objective: In clinical trials, agreement on outcomes is of utmost importance for valid estimation of intervention effects. As there is limited knowledge about adjudicator agreement in cardiology, we examined the level of agreement among three cardiology specialists adjudicating all possible events in a randomized controlled clinical trial of patients with stable coronary heart disease. Study Design and Setting: All information (hospital records, death certificates, etc.) was forwarded to two randomly selected blinded adjudicators. If they disagreed, the third arbiter had to choose the more likely of the two alternatives. Files of 5,475 nonfatal and 362 fatal events were evaluated. Results: For nonfatal outcomes, pairwise kappa values ranged from 0.75 to 0.80. The three adjudicators had 4.3%, 9.5%, and 6.1% of their nonfatal outcome classifications overruled by their arbiter. If stable angina pectoris, unstable angina pectoris, and acute myocardial infarction were treated as one, agreement increased minimally. For fatal outcomes, the pairwise kappa values ranged from 0.65 to 0.90. The three adjudicators had 12%, 9%, and 10% of their death classifications overruled. Conclusion: Specialists in cardiology can attain a reasonably high agreement on outcomes in patients with stable coronary heart disease.

Original language	English
Journal	Journal of Clinical Epidemiology
Volume	65
Issue number	4
Pages (from-to)	444-53
Number of pages	10
ISSN	0895-4356
DOIs	https://doi.org/10.1016/j.jclinepi.2011.09.011
Publication status	Published - Apr 2012

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Kjoller, E., Hilden, J., Winkel, P., Frandsen, N. J., Galatius, S., Jensen, G., Kastrup, J., Hansen, J. F., Kolmos, H. J. J., Jespersen, C. M., Hildebrandt, P., Gluud, C. N., & CLARICOR Trial Group (2012). Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease. Journal of Clinical Epidemiology, 65(4), 444-53. https://doi.org/10.1016/j.jclinepi.2011.09.011

Kjoller, E, Hilden, J, Winkel, P, Frandsen, NJ, Galatius, S, Jensen, G, Kastrup, J, Hansen, JF, Kolmos, HJJ, Jespersen, CM, Hildebrandt, P, Gluud, CN & CLARICOR Trial Group 2012, 'Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease', Journal of Clinical Epidemiology, vol. 65, no. 4, pp. 444-53. https://doi.org/10.1016/j.jclinepi.2011.09.011

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title = "Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease",

abstract = "Objective: In clinical trials, agreement on outcomes is of utmost importance for valid estimation of intervention effects. As there is limited knowledge about adjudicator agreement in cardiology, we examined the level of agreement among three cardiology specialists adjudicating all possible events in a randomized controlled clinical trial of patients with stable coronary heart disease. Study Design and Setting: All information (hospital records, death certificates, etc.) was forwarded to two randomly selected blinded adjudicators. If they disagreed, the third arbiter had to choose the more likely of the two alternatives. Files of 5,475 nonfatal and 362 fatal events were evaluated. Results: For nonfatal outcomes, pairwise kappa values ranged from 0.75 to 0.80. The three adjudicators had 4.3%, 9.5%, and 6.1% of their nonfatal outcome classifications overruled by their arbiter. If stable angina pectoris, unstable angina pectoris, and acute myocardial infarction were treated as one, agreement increased minimally. For fatal outcomes, the pairwise kappa values ranged from 0.65 to 0.90. The three adjudicators had 12%, 9%, and 10% of their death classifications overruled. Conclusion: Specialists in cardiology can attain a reasonably high agreement on outcomes in patients with stable coronary heart disease.",

author = "Erik Kjoller and J{\o}rgen Hilden and Per Winkel and Frandsen, {Niels J} and S{\o}ren Galatius and Gorm Jensen and Jens Kastrup and Hansen, {Jorgen Fischer} and Kolmos, {Hans J{\o}rn Jepsen} and Jespersen, {Christian M} and Per Hildebrandt and Gluud, {Christian Nyfeldt} and Jens Kastrup",

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doi = "10.1016/j.jclinepi.2011.09.011",

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T1 - Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease

AU - Kjoller, Erik

AU - Hilden, Jørgen

AU - Winkel, Per

AU - Frandsen, Niels J

AU - Galatius, Søren

AU - Jensen, Gorm

AU - Kastrup, Jens

AU - Hansen, Jorgen Fischer

AU - Kolmos, Hans Jørn Jepsen

AU - Jespersen, Christian M

AU - Hildebrandt, Per

AU - Gluud, Christian Nyfeldt

AU - CLARICOR Trial Group

PY - 2012/4

Y1 - 2012/4

N2 - Objective: In clinical trials, agreement on outcomes is of utmost importance for valid estimation of intervention effects. As there is limited knowledge about adjudicator agreement in cardiology, we examined the level of agreement among three cardiology specialists adjudicating all possible events in a randomized controlled clinical trial of patients with stable coronary heart disease. Study Design and Setting: All information (hospital records, death certificates, etc.) was forwarded to two randomly selected blinded adjudicators. If they disagreed, the third arbiter had to choose the more likely of the two alternatives. Files of 5,475 nonfatal and 362 fatal events were evaluated. Results: For nonfatal outcomes, pairwise kappa values ranged from 0.75 to 0.80. The three adjudicators had 4.3%, 9.5%, and 6.1% of their nonfatal outcome classifications overruled by their arbiter. If stable angina pectoris, unstable angina pectoris, and acute myocardial infarction were treated as one, agreement increased minimally. For fatal outcomes, the pairwise kappa values ranged from 0.65 to 0.90. The three adjudicators had 12%, 9%, and 10% of their death classifications overruled. Conclusion: Specialists in cardiology can attain a reasonably high agreement on outcomes in patients with stable coronary heart disease.

AB - Objective: In clinical trials, agreement on outcomes is of utmost importance for valid estimation of intervention effects. As there is limited knowledge about adjudicator agreement in cardiology, we examined the level of agreement among three cardiology specialists adjudicating all possible events in a randomized controlled clinical trial of patients with stable coronary heart disease. Study Design and Setting: All information (hospital records, death certificates, etc.) was forwarded to two randomly selected blinded adjudicators. If they disagreed, the third arbiter had to choose the more likely of the two alternatives. Files of 5,475 nonfatal and 362 fatal events were evaluated. Results: For nonfatal outcomes, pairwise kappa values ranged from 0.75 to 0.80. The three adjudicators had 4.3%, 9.5%, and 6.1% of their nonfatal outcome classifications overruled by their arbiter. If stable angina pectoris, unstable angina pectoris, and acute myocardial infarction were treated as one, agreement increased minimally. For fatal outcomes, the pairwise kappa values ranged from 0.65 to 0.90. The three adjudicators had 12%, 9%, and 10% of their death classifications overruled. Conclusion: Specialists in cardiology can attain a reasonably high agreement on outcomes in patients with stable coronary heart disease.

U2 - 10.1016/j.jclinepi.2011.09.011

DO - 10.1016/j.jclinepi.2011.09.011

M3 - Journal article

C2 - 22257841

SN - 0895-4356

VL - 65

SP - 444

EP - 453

JO - Journal of Clinical Epidemiology

JF - Journal of Clinical Epidemiology

IS - 4

ER -

Good interobserver agreement was attainable on outcome adjudication in patients with stable coronary heart disease

Abstract

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