{"title":"药物专家在多大程度上同意州医疗保险数据库中为儿童和青少年开具的精神药物的诊断?","authors":"Conor O’Brien, J. Rapp","doi":"10.1177/25161032211019045","DOIUrl":null,"url":null,"abstract":"This study evaluated the extent to which psychotropic medication experts agreed on psychiatric/behavior diagnoses derived from 30 individuals’ psychotropic medication regimens. Three medication experts reviewed the medication regimens and inferred one or more diagnoses based on the medication listed. Thereafter, we used kappa statistical analyses and category-by-category analyses to evaluate agreement of diagnoses (a) across all three reviewers for two time points (separated by 8 to 14 months) covered by each data set, (b) across each pairing of reviewers at the two time points, and (c) within each reviewer across both time points. Between-reviewer kappa statistical analyses of first- and last-regimen data yielded only five instances with excellent agreement and 13 instances of poor agreement. All remaining instances indicated various levels of disagreement. Similarly, within-expert kappa statistical analyses showed two instances with excellent agreement, four instances with poor agreement, and the remaining instances with various levels of disagreement. Overall, the highest kappa values were attached to low-count regimens, while most scores, regardless of medication count, were low and indicated potential disagreement. The category-by-category analyses yielded similar results. A secondary, conditional analysis revealed higher agreements between and within reviewers when medication regimens contained psychotropic medications typically prescribed to individuals diagnosed with Attention Deficit Hyperactivity Disorder.","PeriodicalId":36239,"journal":{"name":"Developmental Child Welfare","volume":"3 1","pages":"150 - 165"},"PeriodicalIF":0.0000,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/25161032211019045","citationCount":"3","resultStr":"{\"title\":\"To what extent do medication experts agree on diagnoses derived from psychotropic medication prescribed for children and adolescents in a state Medicare database?\",\"authors\":\"Conor O’Brien, J. Rapp\",\"doi\":\"10.1177/25161032211019045\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"This study evaluated the extent to which psychotropic medication experts agreed on psychiatric/behavior diagnoses derived from 30 individuals’ psychotropic medication regimens. Three medication experts reviewed the medication regimens and inferred one or more diagnoses based on the medication listed. Thereafter, we used kappa statistical analyses and category-by-category analyses to evaluate agreement of diagnoses (a) across all three reviewers for two time points (separated by 8 to 14 months) covered by each data set, (b) across each pairing of reviewers at the two time points, and (c) within each reviewer across both time points. Between-reviewer kappa statistical analyses of first- and last-regimen data yielded only five instances with excellent agreement and 13 instances of poor agreement. All remaining instances indicated various levels of disagreement. Similarly, within-expert kappa statistical analyses showed two instances with excellent agreement, four instances with poor agreement, and the remaining instances with various levels of disagreement. Overall, the highest kappa values were attached to low-count regimens, while most scores, regardless of medication count, were low and indicated potential disagreement. The category-by-category analyses yielded similar results. A secondary, conditional analysis revealed higher agreements between and within reviewers when medication regimens contained psychotropic medications typically prescribed to individuals diagnosed with Attention Deficit Hyperactivity Disorder.\",\"PeriodicalId\":36239,\"journal\":{\"name\":\"Developmental Child Welfare\",\"volume\":\"3 1\",\"pages\":\"150 - 165\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-05-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1177/25161032211019045\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Developmental Child Welfare\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/25161032211019045\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Developmental Child Welfare","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/25161032211019045","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Social Sciences","Score":null,"Total":0}
To what extent do medication experts agree on diagnoses derived from psychotropic medication prescribed for children and adolescents in a state Medicare database?
This study evaluated the extent to which psychotropic medication experts agreed on psychiatric/behavior diagnoses derived from 30 individuals’ psychotropic medication regimens. Three medication experts reviewed the medication regimens and inferred one or more diagnoses based on the medication listed. Thereafter, we used kappa statistical analyses and category-by-category analyses to evaluate agreement of diagnoses (a) across all three reviewers for two time points (separated by 8 to 14 months) covered by each data set, (b) across each pairing of reviewers at the two time points, and (c) within each reviewer across both time points. Between-reviewer kappa statistical analyses of first- and last-regimen data yielded only five instances with excellent agreement and 13 instances of poor agreement. All remaining instances indicated various levels of disagreement. Similarly, within-expert kappa statistical analyses showed two instances with excellent agreement, four instances with poor agreement, and the remaining instances with various levels of disagreement. Overall, the highest kappa values were attached to low-count regimens, while most scores, regardless of medication count, were low and indicated potential disagreement. The category-by-category analyses yielded similar results. A secondary, conditional analysis revealed higher agreements between and within reviewers when medication regimens contained psychotropic medications typically prescribed to individuals diagnosed with Attention Deficit Hyperactivity Disorder.