Información del artículo
Resumen
Objetivo
Ningún estudio sobre mutaciones en el oncogén K-ras y los cánceres de páncreas exocrino y del sistema biliar ha analizado la fiabilidad de la información clínica y epidemiológica utilizada. En el contexto de un estudio prospectivo multicéntrico sobre dichas neoplasias se ha analizado la concordancia entre la información facilitada por el paciente y la facilitada por un familiar respecto a diversos factores asociados a aquéllas.
MétodosSe cumplimentaron un total de 110 pares de entrevistas y el acuerdo se midió mediante los índices kappa simple (k) y ponderado (kp), el porcentaje de acuerdo simple, y los porcentajes de acuerdo para los valores positivos y negativos.
ResultadosLa concordancia para los distintos antecedentes patológicos fue excelente (k entre 0,89 y 0,76), al igual que para el consumo habitual de tabaco (k=0,98). El acuerdo fue entre moderado y alto para el consumo habitual de café (k=0,68) y las frecuencias de consumo de grupos de alimentos (kp entre 0,66 y 0,38). Los familiares refirieron sistemáticamente un mayor consumo de bebidas alcohólicas que los pacientes (k entre 0,71 y 0,32).
ConclusiónEn general, los familiares pueden tomarse como fuente de información alternativa en caso de incapacidad de los pacientes, aunque deben considerarse con cautela los datos referentes al consumo de alcohol.
Palabras clave:
Concordancia
Cáncer
Tabaco
Alcohol
Dieta
Antecedentes patológicos
Summary
Objective
No study on mutations in the K-ras oncogene and cancer of the exocrine pancreas or cancer of the biliary system has analyzed the reliability of clinical and epidemiological information.
MethodsAgreement between patient and surrogate on factors potentially related to both tumours was evaluated within a multicentre prospective study. Interviews were personally adminstered to both patient and surrogate (N=110 pairs). Agreement was examined viathe simple kappa index (k), the weighted kappa index (kw), the percentage of simple agreement, and the percentages of positive and negative agreement.
ResultsAgreement for medical history was excellent (k between 0.89 and 0.76), as it was for tobacco consumption (k=0.98). Agreement was moderate for coffee consumption (k=0.68), frequencies of food groups (kw from 0.66 to 0.38), and consumption of alcoholic drinks (k from 0.66 to 0.32). Surrogates indicated a higher consumption of alcohol than patients.
ConclusionSurrogates can be an alternative source of information when patients cannot be interviewed, but information on alcohol consumption should be treated with caution.
Key words:
Concordance
Cancer
Tobacco
Alcohol
Diet
Medical history
El Texto completo está disponible en PDF
Bibliografía
[1.]
L. Nelson, W.T. Longstreth, T.D. Koepsell, G. Van Belle.
Proxy respondents in epidemiologic research.
Epidemiol Rev, 12 (1990), pp. 71-86
[2.]
L.W. Pickle, L. Morris, W.J. Blot.
Information available from surrogate respondents in case-control interview studies.
Am J Epidemiol, 118 (1983), pp. 99-108
[3.]
A. Walker, J.P. Velema, J.M. Robins.
Analysis of case-control data derived in part from proxy respondents.
Am J Epidemiol, 127 (1988), pp. 905-914
[4.]
L. Gordis.
Should dead cases be matched to dead controls?.
Am J Epidemiol, 115 (1982), pp. 1-5
[5.]
J.K. McLaughlin, W.J. Blot, E.S. Mehl, J.S. Mandel.
Problems in the use of dead controls in case-control studies. I. General results.
Am J Epidemiol, 121 (1985), pp. 131-139
[6.]
E. Rogot, D.D. Reid.
The validity of data from next-of-kin in studies of mortality among migrants.
Int J Epidemiol, 4 (1975), pp. 51-54
[7.]
L. Kolonel, T. Hirohata, A.M. Nomura.
Adequacy of survey data collected from substitute respondents.
Am J Epidemiol, 106 (1977), pp. 476-484
[8.]
J. Marshall, R. Priore, B. Haughey, T. Rzepka, T. Graham.
Spouse-subject interviews and the reliability of diet studies.
Am J Epidemiol, 112 (1980), pp. 675-683
[9.]
A. Heyman, W.E. Wilkinson, J.A. Stafford, M.J. Helms, A.H. Sigmon, T. Weinberg.
Alzheimer's disease: a study of epidemiological aspects.
Ann Neurol, 15 (1984), pp. 335-341
[10.]
B.S. Humble, J. Samet, B. Skipper.
Comparison of self and surrogate reported dietary information.
Am J Epidemiol, 119 (1984), pp. 86-98
[11.]
N. Herrmann.
Retrospective information from questionnaires. I. Comparability of primary respondents and their next-of-kin.
Am J Epidemiol, 121 (1895), pp. 937-947
[12.]
M.L. Lerchen, J.M. Samet.
An assessment of the validity of questionnaire responses provided by a surviving spouse.
Am J Epidemiol, 123 (1986), pp. 481-489
[13.]
W.A. Rocca, L. Fratiglioni, L. Bracco, D. Pedone, C. Groppi, B. Schoenberg.
The use of surrogate respondents to obtain questionnaire data in case-control studies of neurologic diseases.
J Chron Dis, 39 (1986), pp. 907-912
[14.]
D.P. Sandler, D.L. Shore.
Quality of data on parents' smoking and drinking provided by adult offspring.
Am J Epidemiol, 124 (1986), pp. 768-778
[15.]
J.K. McLaughlin, M.S. Dietz, E.S. Mehl, W. Blot.
Reliability of surrogate information on cigarette smoking by type of informant.
Am J Epidemiol, 126 (1987), pp. 144-146
[16.]
H.L. Metzner, D.E. Lamphiear, F.E. Thompson, M.S. Oh, V.M. Hawthorne.
Comparison of surrogate and subject reports of dietary practices, smoking habits and weight among married couples in the Tecumseh diet methodology study.
J Clin Epidemiol, 42 (1989), pp. 367-375
[17.]
D.C. Farrow, J.M. Samet.
Comparability of information provided by elderly cancer patients and surrogates regarding health and functional status, social network and life events.
Epidemiology, 1 (1990), pp. 370-376
[18.]
J.K. McLaughlin, J.S. Mandel, E.S. Mehl, W.J. Blot.
Comparison of next-of-kin with self-respondents regarding questions on cigarette, coffee and alcohol consumption.
Epidemiology, 1 (1990), pp. 408-412
[19.]
C.A. Boyle, E.A. Brann.
Proxy respondents and the validity of occupational and other exposure data.
Am J Epidemiol, 136 (1992), pp. 712-721
[20.]
J.L. Lyon, M.J. Egger, L.M. Robinson, T.K. French, R. Gao.
Missclassification of exposure in a case-control study: the effects of different types of exposure and different proxy respondents in a study of pancreatic cancer.
Epidemiology, 3 (1992), pp. 223-231
[21.]
L.M. Nelson, W.T. Longstreth, T.D. Koepsell, H. Checkoway, G. van Belle.
Completeness and accuracy of interview data from proxy respondents: demographic, medical and life-style factors.
Epidemiology, 5 (1994), pp. 204-217
[22.]
A.L. Warshaw, C. Fernández del Castillo.
Pancreatic carcinoma.
N Engl J Med, 326 (1992), pp. 455-465
[23.]
P. Watapana, R.C. Williamson.
Surgical palliation for pancreatic cancer: development during the past two decades.
Br J Surg, 79 (1992), pp. 8-20
[24.]
J.L. Cameron, D.W. Crist, J.V. Sitzmann, et al.
Factors influencing survival after pancreaticoduodenectomy for pancreatic cancer.
Am J Surg, 161 (1991), pp. 120-124
[25.]
D. Farrow, S. Davis.
Diet and the risk of pancreatic cancer in men.
Am J Epidemiol, 132 (1990), pp. 423-431
[26.]
J.L. Lyon, A.W. Mahoney, T.K. French, R. Moser.
Coffee consumption and the risk of cancer of exocrine pancreas: a case-control study in low-risk population.
Epidemiology, 3 (1992), pp. 164-170
[27.]
P. Ghadirian, A. Simard, J. Baillargeon, P. Maisonneuve, P. Boyle.
Nutritional factors and pancreatic cancer in the francophone community in Montréal, Canada.
Int J Cancer, 47 (1991), pp. 1-6
[28.]
P. Ghadirian, A. Simard, J. Baillargeon.
Tobacco, alcohol and coffee and cancer of the pancreas. A population-based, case-control study in Québec, Canada.
Cancer, 67 (1991), pp. 2664-2670
[29.]
H.B. Bueno de Mesquita, C.J. Moerman, S. Runia, P. Maisonneuve.
Are energy and energy-providing nutrients related to exocrine carcinoma of the pancreas?.
Int J Cancer, 46 (1990), pp. 435-444
[30.]
H.B. Bueno de Mesquita, P. Maisonneuve, C.J. Moerman, S. Runia, P. Boyle.
Life-time history of smoking and exocrine carcinoma of the pancreas: a population-based case-control study in The Netherlands.
Int J Cancer, 49 (1991), pp. 816-822
[31.]
H.B. Bueno de Mesquita, P. Maisonneuve, S. Runia, C.J. Moerman.
Intake of foods and nutrients and cancer of the exocrine pancreas: a population-based case-control study in the Netherlands.
Int J Cancer, 48 (1991), pp. 540-549
[32.]
H.B. Bueno de Mesquita, P. Maisonneuve, C.J. Moerman, S. Runia, P. Boyle.
Life-time consumption of alcoholic beverages, tea and coffe and exocrine carcinoma of the pancreas: a population-based case-control study in the Netherlands.
Int J Cancer, 50 (1992), pp. 514-522
[33.]
E.B. Gold, L. Gordis, M.D. Diener, R. Seltser, J.K. Boitnott, T.E. Bynum.
Diet and other risk factors for cancer of the pancreas.
Cancer, 55 (1985), pp. 460-467
[34.]
W. Zatonski, K. Przewozniak, G.R. Howe, P. Maisonneuve, A.M. Walker, P. Boyle.
Nutritional factors and pancreatic cancer: a case-control study from South-west Poland.
Int J Cancer, 48 (1991), pp. 390-394
[35.]
B.S. Hulka.
Epidemiological studies using biological markers: issues for epidemiologists.
Cancer Epidemiol Biomarkers Prev, 1 (1991), pp. 13-19
[36.]
M. Porta Serra, N. Malats, J.L. Piñol, J. Rifà.
Epidemiología molecular [carta].
Med Clín (Barc), 100 (1993), pp. 475
[37.]
M. Porta, F.X. Real, N. Malats, J. Rifá, L. Guarner, A. Carrato, et al.
Role of mutations in K-ras and p53 genes in exocrine pancreatic cancer and cancer of the extrahepatic biliary system (The PANKRAS II Study).
Directory of on-going research in cancer epidemiology, 1994, pp. 306
[38.]
D.L. Sackett, B. Haynes, R.B. Guyatt, P. Tugwell.
Clinical epidemiology: A basic science for clinical medicine.
2ª ed, pp. 51-68
[39.]
R.H. Fletcher, S.W. Fletcher, E.H. Wagner.
Epidemiología clínica.
pp. 41-73
[40.]
I. Hernández Aguado, A.M. García García.
La evaluación de pruebas diagnósticas en España. Una aproximación crítica.
Revisiones Salud Pública, 3 (1993), pp. 243-262
[41.]
F. Pozo Rodríguez.
La eficacia de las pruebas diagnósticas (I).
Med Clín (Barc), 90 (1988), pp. 779-785
[42.]
P. Stork, M. Loda, S. Bosari, B. Wiley, K. Poppenhusen, H. Wolfe.
Detection of K-ras mutations in pancreatic and hepatic neoplasms by non-isotopic mismatched polymerase chain reaction.
Oncogene, 6 (1991), pp. 857-862
[43.]
M. Tada, O. Yokosuka, M. Omata, M. Ohto, K. Isono.
Analysis of ras gene mutations in biliary and pancreatic tumors band polymerase chain reaction and direct sequencing.
Cancer, 66 (1990), pp. 930-935
[44.]
M. Tada, M. Omata, M. Ohto.
Clinical application of ras gene mutation for diagnosis of pancreatic adenocarcinoma.
Gastroenterology, 100 (1991), pp. 233-238
[45.]
T. Urban, S. Ricci, J.D. Grange, R. Lacave, F. Boudghene, F. Breittmayer, et al.
Detection of c-Ki-ras mutation by PCR/RFLP analysis and diagnosis of pancreatic adenocarcinomas.
J Natl Cancer Inst, 85 (1993), pp. 2008-2012
[46.]
J.L. Fleiss.
Statistical methods for rates and proportions.
pp. 212-236
[47.]
M.S. Kramer, A.R. Feinstein.
The biostatistics of concordance.
Clin Pharmacol Ther, 29 (1981), pp. 11-23
[48.]
A.R. Feinstein, D.V. Cicchetti.
High agreement but low kappa. II: Resolving the paradoxes.
J Clin Epidemiol, 43 (1990), pp. 551-558
[49.]
J.M. Grant.
The fetal heart rate trace is normal, isn't it? Observer agreement for categorical assessments.
Lancet, 337 (1991), pp. 215-218
[50.]
J.M. Martín-Moreno, P. Boyle, L. Gorgojo, P. Maisonneuve, J.C. Fernández-Rodríguez, S. Salvini, et al.
Development and validation of a food frequency questionnaire in Spain.
Int J Epidemiol, 22 (1993), pp. 512-527
[51.]
A.R. Feinstein, D.V. Cicchetti.
High agreement but low kappa. I: The problems of two paradoxes.
J Clin Epidemiol, 43 (1990), pp. 543-549
[52.]
M. Maclure, W.C. Willett.
Misinterpretation and misuse of the kappa statistic.
Am J Epidemiol, 126 (1987), pp. 161-168
[53.]
I. Hernández Aguado, M. Porta Serra, M. Miralles, F. García Benavides, F. Bolúmar.
La cuantificación de la variabilidad en las observaciones clínicas.
Med Clín (Barc), 95 (1990), pp. 424-429
[54.]
M. Porta Serra, F. Sanz Carreras, a. Prólogo, S.B. Hulley, S.R. Cummings.
Diseño de la investigación clínica.
Un enfoque epidemiológico, pp. vii-x
[55.]
N. Malats, M. Porta, E. Fernandez, F.X. Real.
Detection of c-Ki-ras mutation by PCR/RFLP analysis and diagnosis of pancreatic adenocarcinomas.
J Natl Cancer Inst, 86 (1994), pp. 1353-1354
[56.]
H. Brenner, D.A. Savitz.
The effects of sensitivity and specificity of case selection on validity, sample size, precision, and power in hospital-based case-control studies.
Am J Epidemiol, 132 (1990), pp. 181-192
[57.]
M. Porta Serra, C. Álvarez-Dardet, F. Bolúmar, A. Plasència, E. Velilla.
La calidad de la información clínica. I: validez.
Med Clín (Barc), 89 (1987), pp. 741-747
[58.]
D.G. Kleinbaum, L.L. Kupper, H. Morgenstern.
Epidemiologic research.
Principles and quantitative methods, pp. 220-241
La lista de todos los investigadores aparece al final del artículo.
Copyright © 1995. Sociedad Española de Salud Pública y Administración Sanitaria
