Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients
Validation of self-report of influenza and pneumococcal vaccination status in elderly outpatients
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DOI：
10.1016/s0749-3797(98)00159-7
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发表时间：
1999-04-01
影响因子：
5.5
通讯作者：
Nichol, KL
中科院分区：
文献类型：
--
作者：
Mac Donald, R;Baken, L;Nichol, KL
目的：评价自我报告的流感和肺炎球菌疫苗接种情况的有效性。设计：对65岁及以上的门诊患者进行横断面调查。环境：退伍军人事务医疗中心（VA）和社区管理医疗组织（MCO）。这两个组织都组织了流感和肺炎球菌疫苗接种项目。受试者：VA受试者包括所有老年人，随机选择500名门诊患者邮寄问卷。MCO的研究对象包括随机选择的300名老年MCO成员的电话调查的所有受访者。测量方法：VA调查是在1995-1996年流感季节之后进行的，而MCO调查是在1994-1995年流感季节之后进行的。VA受试者的邮寄问卷和MCO受试者的电话调查的自我报告与医疗记录文件（纸质和计算机结合）进行比较。结果：VA受试者的有效率为77% (n = 369)，其中195人（53%）年龄在65岁及以上。MCO受试者的应答率为84% （n = 237）。自我报告流感疫苗接种的敏感性（SENS）为1.0，特异性（SPEC）为。kappa为。72例（95% CI 0.58 - 0.86）。在MCO患者中，自我报告流感疫苗接种的SENS为。和一份规格说明。与…一起…75 （95% ci .69- 0.89）。VA患者自我报告肺炎球菌疫苗接种状况的SENS为。的规格。53的kappa。42 （95%ci .32-.52）。在MCO患者中，自我报告的肺炎球菌疫苗接种SENS为。90和规格的。61， kappa为。54 （95%ci 0.40 - 0.68）。二次分析排除了居住在VA集水区以外的受试者，提高了流感和肺炎球菌疫苗接种自我报告的特异性和一致性指数。第二项：对MCO数据的分析（排除了在研究前2年接种肺炎球菌疫苗的受试者）也提高了一致性和自我报告的阴性预测值。自我报告流感疫苗接种是一种高度敏感和中等特异性的措施。结论：肺炎球菌疫苗接种的自我报告也是一种高度敏感但特异性较低的疫苗接种状况测量方法。肺炎球菌疫苗的有效性较低可能反映了召回率较低，特别是对于较远的疫苗接种，以及医疗记录中记录的不完整。(C) 1999美国预防医学杂志。
Objective: To assess the validity of self-reported influenza and pneumococcal vaccination status.Design: Cross-sectional surveys of outpatients aged 65 years or older.Setting: A Veterans Affairs Medical Center (VA) and a community managed care organization (MCO). Both organizations have organized influenza and pneumococcal vaccination programs.Subjects: VA subjects included all elderly respondents to a mailed sun ey of 500 randomly selected outpatients. MCO subjects included all respondents to a telephone survey of 300 randomly selected elderly members of the MCO.Measurements:The VA survey was conducted following the 1995-1996 influenza season while the MCO survey was conducted following the 1994-1995 season. Self-report from the mailed sun ey for VA subjects and from the telephone survey for MCO subjects was compared to medical record documentation (paper and computerized combined).Results: The response rate was 77% (n = 369) for the VA subjects of whom 195 (53%) were aged 65 or older. The response rate for the MCO subjects was 84% (n = 237). Self-report of influenza vaccination had a sensitivity (SENS) of 1.0 and a specificity (SPEC) of .79 with a kappa of .72 (95% CI .58-.86) among VA patients. Among MCO patients, self-report of influenza vaccination had a SENS of .98 and a SPEC of .71 with kappa of .75 (95% CI .69-.89). Self-report of pneumococcal vaccination status among VA patients had a SENS of .97 and a SPEC of .53 with a kappa of .42 (95%CI .32-.52). Among MCO patients, self-report of pneumococcal vaccination had a SENS of .90 and a SPEC of .61 with a kappa of .54 (95%CI .40-.68). A secondary analysis excluding subjects living outside of the VA's catchment area improved the specificity and indices of concordance of self-report of both influenza and pneumococcal vaccination. A secondary: analysis of MCO data which excluded subjects who received a pneumococcal vaccination > 2 years prior to the study also improved concordance and the negative predictive value of self-report. Self-report of influenza vaccination is a highly sensitive and moderately specific measure.Conclusion: Self-report of pneumococcal vaccination is also a highly sensitive but less specific measure of vaccination status. Lower rates of validity for pneumococcal vaccination may reflect both less accurate recall, particularly for more distant vaccination, and less complete documentation in medical records. (C) 1999 American Journal of Preventive Medicine.