PMID: 9420642Mar 1, 1995Paper

Interobserver discordance in the classification of mechanisms of death in studies of heart failure

Journal of Cardiac Failure
S ZiescheJ N Cohn

Abstract

Studies of the mechanism of death in heart failure are dependent on the reliability and validity of classification of deaths as pump failure or arrhythmias (sudden). Two recent trials differed in that the Vasodilator Heart Failure Trial II (V-HeFT II) reported a higher incidence of sudden death than the Studies of Left Ventricular Dysfunction Treatment Trial (SOLVD) and an effect of enalapril on sudden death was not observed in SOLVD. A similar classification system was used in the two studies, but deaths in V-HeFT were classified centrally from a narrative summary, whereas deaths in SOLVD were classified in the field by individual investigators. To examine reliability, 10 narratives used to classify V-HeFT deaths were independently classified by 21 SOLVD investigators. In only 5 of 10 cases did 75% of SOLVD investigators agree with the V-HeFT classification. In no deaths were all SOLVD investigators in agreement on classification. Although V-HeFT classified 5 of 10 cases as sudden death, 16 of 21 SOLVD investigators classified less than 5 deaths as sudden and 1 classified none as sudden. The kappa statistic for interobserver agreement of 0.22 (P < or = .01) indicated interobserver agreement only slightly better than chance agr...Continue Reading

References

Aug 1, 1991·The New England Journal of Medicine·UNKNOWN SOLVD InvestigatorsJay N Cohn
Mar 1, 1982·Circulation·L E Hinkle, H T Thaler

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Citations

Dec 17, 2002·Heart·P A Poole-WilsonUNKNOWN Atlas Study Group. Assessment of treatment with lisinopril and survival
Sep 7, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Daniel B KramerRobert G Hauser
Jun 1, 1995·Journal of Cardiac Failure·J N Cohn
Mar 31, 2000·American Heart Journal·C M O'ConnorT J Ryan
Nov 16, 2004·European Journal of Heart Failure·Natan CohenOleg Gorelik
Nov 13, 2004·The American Journal of Geriatric Cardiology·Mary Clare DerflerPaul J Hauptman
Oct 8, 2008·European Journal of Heart Failure·Paresh A MehtaMartin R Cowie
Jan 1, 1996·Journal of Cardiovascular Pharmacology and Therapeutics·B N Singh

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