Reliability and validity of ICPC-2-R encoding by medical students

• Autor(a) principal: Fontenelle, Leonardo Ferreira
• Data de Publicação: 2018
• Outros Autores: Zamprogno, Álvaro Damiani, Rodrigues, André Filipe Lucchi, Sirtoli, Lorena Camillato, Checon, Natália Josiele Cerqueira, Vetis, Marcelo Santana, Brandão, Diego José
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista Brasileira de Medicina de Família e Comunidade (Online)
• Texto Completo: https://www.rbmfc.org.br/rbmfc/article/view/1655
• topic: Primary Health Care/classification; Observer Variation; Reproducibility of Results; Education; Medical; Undergraduate; Clinical Clerkship; ICPC-2; Atención Primaria de Salud/clasificación; Variaciones Dependientes del Observador; Reproducibilidad de Resultados; Educación de Pregrado en Medicina; Prácticas Clínicas; Atenção Primária à Saúde/classificação; Variações Dependentes do Observador; Reprodutibilidade dos Testes; Educação de Graduação em Medicina; Estágio Clínico

Objective: To estimate how reliably and validly can medical students encode reasons for encounter and diagnoses using the International Classification of Primary Care, revised 2nd edition (ICPC-2-R). Methods: For every encounter they supervised during an entire semester, three family and community physician teachers entered the reasons for encounter and diagnoses in free text into a form. Two of four medical students and one teacher encoded each reason for encounter or diagnosis using the ICPC-2-R. In the beginning of the study, two three-hour workshops were held, until the teachers were confident the students were ready for the encoding. After all the reasons for encounter and the diagnoses had been independently encoded, the seven encoders resolved the definitive codes by consensus. We defined reliability as agreement between students and validity as their agreement with the definitive codes, and used Gwet’s AC1 to estimate this agreement. Results: After exclusion of encounters encoded before the last workshop, the sample consisted of 149 consecutive encounters, comprising 262 reasons for encounter and 226 diagnoses. The encoding had moderate to substantial reliability (AC1, 0.805; 95% CI, 0.767–0.843) and substantial validity (AC1, 0.864; 95% CI, 0.833–0.891). Conclusion: Medical students can encode reasons for encounter and diagnoses with the ICPC-2-R if they are adequately trained.