PDF
ePub
Citation
Print
Abstract
Objective
Self-report questionnaires are frequently used to obtain information in epidemiological research. However, information reported by patients are sometimes inconsistent with medical records. This study compared self-reported major rheumatologic diagnoses and comorbid conditions with those from a medical record review.
Methods
A cross-sectional survey was conducted at two tertiary academic hospitals. All patients who visited the rheumatology department from September 2, 2009 to September 13, 2009 were enrolled in this survey. Structured patient questionnaires and medical record reviews were performed in each hospital. We evaluated agreement with kappa statistics (κ) between these two data sources for major rheumatologic diagnosis and Charlson Comorbidity Index (CCI) score. Multiple logistic regression models were used to investigate factors associated with disagreement.
Results
A total of 369 patients were interviewed at clinic exit. Of them, 302 patients (81.8%) were female, and the average age was 52.1 years. The agreement for major rheumatologic diagnosis between the questionnaire and patient chart was good (κ=0.763). The agreement rate for all rheumatic diseases was 81.8%; rheumatoid arthritis with 94.9%, systemic lupus erythematosus with 96.3%, and ankylosing spondylopathy with 100%. Higher educational level and longer attendance at our clinic were associated with agreement between major rheumatologic diagnoses. The agreement rate for CCI score between the data sources was 76.1%.
REFERENCES
1. Reis C, Viana Queiroz M. Prevalence of self-reported rheumatic diseases in a Portuguese population. Acta Reumatol Port. 2014; 39:54–9.
2. Li R, Sun J, Ren LM, Wang HY, Liu WH, Zhang XW, et al. Epidemiology of eight common rheumatic diseases in China: a large-scale cross-sectional survey in Beijing. Rheumatology (Oxford). 2012; 51:721–9.
3. Wolfe F, Michaud K. Data collection, maintenance, and analysis for rheumatic disease research. Rheum Dis Clin North Am. 2004; 30:753–68.
4. Alarcón GS, Roseman J, Bartolucci AA, Friedman AW, Moulds JM, Goel N, et al. Systemic lupus erythematosus in three ethnic groups: II. Features predictive of disease activity early in its course. LUMINA Study Group. Lupus in minority populations, nature versus nurture. Arthritis Rheum. 1998; 41:1173–80.
5. Jordan J, Luta G, Renner J, Dragomir A, Hochberg M, Fryer J. Knee pain and knee osteoarthritis severity in self-reported task specific disability: the Johnston County Osteoarthritis Project. J Rheumatol. 1997; 24:1344–9.
6. Pincus T, Sokka T, Kavanaugh A. Quantitative documentation of benefit/risk of new therapies for rheumatoid arthritis: patient questionnaires as an optimal measure in standard care. Clin Exp Rheumatol. 2004; 22(5 Suppl 35):S26–33.
7. Fransen J, Langenegger T, Michel BA, Stucki G. Feasibility and validity of the RADAI, a self-administered rheumatoid arthritis disease activity index. Rheumatology (Oxford). 2000; 39:321–7.
8. Walitt BT, Constantinescu F, Katz JD, Weinstein A, Wang H, Hernandez RK, et al. Validation of self-report of rheumatoid arthritis and systemic lupus erythematosus: The Women's Health Initiative. J Rheumatol. 2008; 35:811–8.
9. Solomon DH, Stedman M, Licari A, Weinblatt ME, Maher N, Shadick N. Agreement between patient report and medical record review for medications used for rheumatoid arthritis: the accuracy of self-reported medication information in patient registries. Arthritis Rheum. 2007; 57:234–9.
10. Formica MK, McAlindon TE, Lash TL, Demissie S, Rosenberg L. Validity of self-reported rheumatoid arthritis in a large cohort: results from the Black Women's Health Study. Arthritis Care Res (Hoboken). 2010; 62:235–41.
11. Chaudhry S, Jin L, Meltzer D. Use of a self-report-generated Charlson Comorbidity Index for predicting mortality. Med Care. 2005; 43:607–15.
12. Cho SK, Sung YK, Choi CB, Bae SC. Impact of comorbidities on TNF inhibitor persistence in rheumatoid arthritis patients: an analysis of Korean National Health Insurance claims data. Rheumatol Int. 2012; 32:3851–6.
13. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40:373–83.
14. Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994; 47:1245–51.
15. Tuominen U, Blom M, Hirvonen J, Seitsalo S, Lehto M, Paavolainen P, et al. The effect of comorbidities on health-related quality of life in patients placed on the waiting list for total joint replacement. Health Qual Life Outcomes. 2007; 5:16.
16. Lash TL, Mor V, Wieland D, Ferrucci L, Satariano W, Silliman RA. Methodology, design, and analytic techniques to address measurement of comorbid disease. J Gerontol A Biol Sci Med Sci. 2007; 62:281–5.
17. Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GA. Causes and consequences of comorbidity: a review. J Clin Epidemiol. 2001; 54:661–74.
18. Seo HJ, Yoon SJ, Lee SI, Lee KS, Yun YH, Kim EJ, et al. A comparison of the Charlson comorbidity index derived from medical records and claims data from patients undergoing lung cancer surgery in Korea: a population-based investigation. BMC Health Serv Res. 2010; 10:236.
19. Byrt T, Bishop J, Carlin JB. Bias, prevalence and kappa. J Clin Epidemiol. 1993; 46:423–9.
20. Barlow JH, Turner AP, Wright CC. Comparison of clinical and self-reported diagnoses for participants on a commun-ity-based arthritis self-management programme. Br J Rheumatol. 1998; 37:985–7.
21. Costenbader KH, Feskanich D, Mandl LA, Karlson EW. Smoking intensity, duration, and cessation, and the risk of rheumatoid arthritis in women. Am J Med. 2006; 119:503.e1-9.
22. Karlson EW, Lee IM, Cook NR, Manson JE, Buring JE, Hennekens CH. Comparison of self-reported diagnosis of connective tissue disease with medical records in female health professionals: the Women's Health Cohort Study. Am J Epidemiol. 1999; 150:652–60.
23. McAlindon TE, Formica M, Palmer JR, Lafyatis R, Rosenberg L. Assessment of strategies for identifying diagnosed cases of systemic lupus erythematosus through self-report. Lupus. 2003; 12:754–9.
24. Skinner KM, Miller DR, Lincoln E, Lee A, Kazis LE. Concordance between respondent self-reports and medical records for chronic conditions: experience from the Veterans Health Study. J Ambul Care Manage. 2005; 28:102–10.
25. Corser W, Sikorskii A, Olomu A, Stommel M, Proden C, Holmes-Rovner M. Concordance between comorbidity data from patient self-report interviews and medical record documentation. BMC Health Serv Res. 2008; 8:85.
26. Tisnado DM, Adams JL, Liu H, Damberg CL, Chen WP, Hu FA, et al. What is the concordance between the medical record and patient self-report as data sources for ambulatory care? Med Care. 2006; 44:132–40.
27. Byles JE, D'Este C, Parkinson L, O'Connell R, Treloar C. Single index of multimorbidity did not predict multiple outcomes. J Clin Epidemiol. 2005; 58:997–1005.
28. Kvien TK, Glennås A, Knudsrød OG, Smedstad LM. The validity of self-reported diagnosis of rheumatoid arthritis: results from a population survey followed by clinical examinations. J Rheumatol. 1996; 23:1866–71.
29. Klungel OH, de Boer A, Paes AH, Seidell JC, Bakker A. Cardiovascular diseases and risk factors in a population-based study in The Netherlands: agreement between questionnaire information and medical records. Neth J Med. 1999; 55:177–83.
30. Simpson CF, Boyd CM, Carlson MC, Griswold ME, Guralnik JM, Fried LP. Agreement between self-report of disease diagnoses and medical record validation in disabled older women: factors that modify agreement. J Am Geriatr Soc. 2004; 52:123–7.
31. Linet MS, Harlow SD, McLaughlin JK, McCaffrey LD. A comparison of interview data and medical records for previous medical conditions and surgery. J Clin Epidemiol. 1989; 42:1207–13.
32. Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996; 34:73–84.
33. Colditz GA, Martin P, Stampfer MJ, Willett WC, Sampson L, Rosner B, et al. Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol. 1986; 123:894–900.
34. Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum. 2003; 49:156–63.
35. Okura Y, Urban LH, Mahoney DW, Jacobsen SJ, Rodeheffer RJ. Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure. J Clin Epidemiol. 2004; 57:1096–103.
Figure 1.
Comparison of frequency of comorbid conditions between self-reports and medical records. DM: diabetes mellitus, PABAK: prevalence-adjusted and bias-adjusted kappa.
Table 1.
Demographic and clinical characteristics of enrolled patients (n=369)
Table 2.
Agreement of major rheumatologic diagnosis between self-reports and medical records
Table 3.
Factors influencing disagreement of major rheumatologic diagnosis or CCI
XML Download