Journal Article

Agreement between public register and adjudication committee outcome in a cardiovascular randomized clinical trial

Gluud, Christian, Fischer Hansen, Jørgen, Kastrup, Jens, Kjøller, Erik, Hilden, Jørgen, Jespersen, Christian M., Hildebrandt, Per, Winkel, Per, Galatius, Søren, Jensen, Gorm B., Frandsen, Niels Jørgen, Kolmos, Hans Jørn

2014

Overview

The objective of this study is to describe the agreement between randomized trial outcome assessment by committee and outcomes entirely identified through public registers. In the CLARICOR trial, 4,372 patients with stable coronary heart disease received a short course of clarithromycin versus placebo and were followed up for 2.6 years. The pertinent hospital records and death certificates had originally been evaluated by the adjudication committee using common definitions of outcomes mapped into a 6-category list. We now mechanically converted the International Classification of Diseases–coded diagnoses of the public registries into the same categories. After cross-tabulation of the committee diagnoses with National Patient Register diagnoses and Register of Causes of Death, we calculate agreement and compare the estimated intervention effects of the 2 data sets. With public register data, the protocol-specified categories were slightly more frequent. Overall agreement was 74% for hospital discharges and 60% for cause of death, but the intervention effect, expressed as a hazard ratio, stayed within 4% of the value originally obtained with the adjudication committee (P≥ .35). Our results show a modest agreement between formal adjudication and outcomes deducible from public registers. However, the estimated intervention effect did not differ noticeably between the 2 data sources. If studies on a wide range of public registers confirm these findings, register outcomes may be considered as a replacement for adjudication committees.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Agreements / Algorithms / Angina pectoris / Cardiovascular / Cardiovascular disease / Cardiovascular Diseases - mortality / Cause of Death / Classification / Clinical trials / Clinical Trials Data Monitoring Committees / Codes / Family physicians / Heart attacks / Hospitalization / Humans / Mortality / Myocardial Ischemia - mortality / Outcome Assessment, Health Care / Patients / Randomized Controlled Trials as Topic / Registries - standards / Reproducibility of Results