Suggestions(1)
Exact(3)
Four [19], [20], [23], [24] of the twelve indication classifications presented only theoretical models.
Specifically, in the indication classifications, terms/diagnoses such as fetal distress, dystocia, failure to progress, cephalo-pelvic disproportion, obstructed labor, macrosomia, failed induction and failed trial of labor would need to be more clearly defined using unambiguous and preferably evidence-based terminology.
Similar data were collected on sigmoidoscopy, double contrast barium enema (BE), and CT colonography (CTC), which aided in indication classifications.
Similar(57)
indication classification in the CMC database, Table S13.
Thus, the details in the medical records are necessary for accurate indication classification.
In our study, we found no single gold-standard source of information in the medical records for indication classification that agreed consistently with expert adjudication, and the data sources were complementary in achieving better indication classification.
We then examined whether the differences in indication classification across data sources affected estimates of the effect of screening.
Accurate indication classification is critical for obtaining unbiased estimates of colonoscopy effectiveness and quality improvement efforts, but there is a dearth of published systematic classification approaches.
Thus, it can be spuriously low when expected agreement is high, as could occur in the case of indication classification due to high correlation among data sources.
Indication classification without expert review resulted in a 2.4-34.92.4-34.9%on from the adjudicated standard in the estimated effects of screening colonoscopy.
This can lead to unexpected results when evaluating the effectiveness of colonoscopy in observational data, [ 15, 26] underscoring the need for a standardized approach for indication classification.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com