Consistency analysis of the chief inspection conclusions in physical examination reports

Objective To analyze the consistency of individual examination diagnosis with terminologies expressed in the conclusion report of physical examinations by the chief inspection physician. Methods Based on the clinical classifications used in the Guidelines on Prevention and Treatment of Blood Lipid Abnormality for Chinese Adults, and related terminology descriptions of Dyslipidemias that were actually used in four-item blood lipid examinations diagnosis, a lexicon database of Hyperlipidemias was constructed with 39 terms used in the four-item blood lipid examination diagnosis and chief physician conclusions. Totally 11 953 electronic chief physician inspection reports from 8 health check-up institutions were included. We investigated the terms of lexicon database using word frequency analysis method, calculated the positive rate in the diagnosis of four single examinations of serum lipid and the positive rate in the chief physician's conclusion. Consistency of chief physician's conclusion with single examination diagnosis was analyzed by Kappa test. Results (1) Among the 39 terms of lexicon database, there are 18 nonstandard terms used in single examination diagnosis, accounted for 46% of all terms; (2) In word frequency analysis, there are only 1% of terms that corresponded to clinical classifications of Hyperlipidemias accurately; (3) The positive rate of Hyperlipidemias in serum lipid four single examinations diagnosis was 47%, the positive rate of physician diagnosis was 35%. The consistency analysis of chief physician conclusions with single examination diagnosis showed Kappa=0.71(P 0.75 may be suggested as a favorable value. Key words: Diagnostic services; Dyslipidemias; Text mining; Consistency