TY - JOUR
T1 - Accuracy and interrater agreement of death event adjudications by physician trainees
T2 - validation of the ISTH definition of pulmonary embolism-related death in an autopsy cohort
AU - Marx, Caterina E.
AU - Schenker, Carla
AU - Xu, Yan
AU - Salvatore, Steven P.
AU - Kahn, Susan R.
AU - Garcia, David
AU - Delluc, Aurélien
AU - Kraaijpoel, Noémie
AU - Langlois, Nicole
AU - Girard, Philippe
AU - le Gal, Grégoire
AU - Tritschler, Tobias
N1 - Funding Information: Funding information S.R. Kahn, A. Delluc, N. Langlois, G. Le Gal, and T. Tritschler are members of the Canadian Venous Thromboembolism Research Network (CanVECTOR); the Network received grant funding from the Canadian Institutes of Health Research (Funding Reference: CDT-142654). S.R. Kahn holds a Tier 1 Canada Research Chair in venous thromboembolism. A. Delluc is recipient of a University of Ottawa Department of Medicine Research Salary Award. G. Le Gal holds a mid-career clinician scientist award from the Heart and Stroke Foundation of Ontario, and the Chair on the Diagnosis of Venous Thromboembolism, Department of Medicine, University of Ottawa.Our findings are consistent with our previous validation study. They further support the use of the ISTH definition of PE-related death and revealed high agreement between adjudicators with varied experience.In conclusion, adjudication of the cause of death by a CAC composed of physician trainees using the ISTH definition of PE-related death resulted in a perfect specificity, moderate sensitivity, and good interrater agreement for autopsy-confirmed PE-related death. Combined with the results of a previous study, our findings further support the use of the ISTH definition of PE-related death in clinical VTE studies and demonstrated high agreement between adjudicators with different clinical and adjudication experience. Publisher Copyright: © 2023 International Society on Thrombosis and Haemostasis
PY - 2023/10
Y1 - 2023/10
N2 - Background: We previously determined good agreement and high specificity of the International Society on Thrombosis and Haemostasis (ISTH) definition of pulmonary embolism (PE)-related death among an expert central adjudication committee (CAC). CACs are often composed of experts in the corresponding research field. Involving physician trainees in CACs would allow investigators to divide the workload and foster trainees’ research experience. Objective: To evaluate the accuracy of the ISTH definition of PE-related death for PE- versus non–PE-related deaths as confirmed by autopsy and its interrater agreement among physician trainees. Methods: This retrospective autopsy cohort included all patients with PE-related deaths between January 2010 and July 2019 as well as patients who died in 2018 from a cause other than PE at the New York-Presbyterian Hospital. Based on premortem clinical summaries, two physician trainees independently determined the cause of death using the ISTH definition of PE-related death. We calculated the sensitivity and specificity of the ISTH definition to identify autopsy-confirmed PE-related death and its interrater agreement. Results: Overall, 126 death events were adjudicated (median age, 68 years; 60 [48%] women), of which 29 (23%) were due to PE, as confirmed by autopsy. Sensitivity and specificity of the ISTH definition for autopsy-confirmed PE-related death was 48% (95% CI, 29-67) and 100% (95% CI, 96-100), respectively. Interrater reliability for PE-related death was good (percentage agreement, 93%; 95% CI, 87-96, Cohen's Kappa, 0.67; 95% CI, 44-85). Conclusion: Our findings are consistent with our previous validation study. They further support the use of the ISTH definition of PE-related death and revealed high agreement between adjudicators with varied experience.
AB - Background: We previously determined good agreement and high specificity of the International Society on Thrombosis and Haemostasis (ISTH) definition of pulmonary embolism (PE)-related death among an expert central adjudication committee (CAC). CACs are often composed of experts in the corresponding research field. Involving physician trainees in CACs would allow investigators to divide the workload and foster trainees’ research experience. Objective: To evaluate the accuracy of the ISTH definition of PE-related death for PE- versus non–PE-related deaths as confirmed by autopsy and its interrater agreement among physician trainees. Methods: This retrospective autopsy cohort included all patients with PE-related deaths between January 2010 and July 2019 as well as patients who died in 2018 from a cause other than PE at the New York-Presbyterian Hospital. Based on premortem clinical summaries, two physician trainees independently determined the cause of death using the ISTH definition of PE-related death. We calculated the sensitivity and specificity of the ISTH definition to identify autopsy-confirmed PE-related death and its interrater agreement. Results: Overall, 126 death events were adjudicated (median age, 68 years; 60 [48%] women), of which 29 (23%) were due to PE, as confirmed by autopsy. Sensitivity and specificity of the ISTH definition for autopsy-confirmed PE-related death was 48% (95% CI, 29-67) and 100% (95% CI, 96-100), respectively. Interrater reliability for PE-related death was good (percentage agreement, 93%; 95% CI, 87-96, Cohen's Kappa, 0.67; 95% CI, 44-85). Conclusion: Our findings are consistent with our previous validation study. They further support the use of the ISTH definition of PE-related death and revealed high agreement between adjudicators with varied experience.
KW - adjudication
KW - cause of death
KW - pulmonary embolism
KW - reproducibility of results
KW - validation study
KW - venous thromboembolism
UR - http://www.scopus.com/inward/record.url?scp=85167977347&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jtha.2023.07.015
DO - https://doi.org/10.1016/j.jtha.2023.07.015
M3 - Article
C2 - 37517478
SN - 1538-7933
VL - 21
SP - 2908
EP - 2912
JO - Journal of thrombosis and haemostasis
JF - Journal of thrombosis and haemostasis
IS - 10
ER -