Validation of self-reported complications by bone marrow transplantation survivors
Validation of self-reported complications by bone marrow transplantation survivors
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DOI：
10.1038/sj.bmt.1702419
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发表时间：
2000-06-01
影响因子：
4.8
通讯作者：
Bhatia, S
中科院分区：
文献类型：
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作者：
Louie, AD;Robison, LL;Bhatia, S
自填问卷通常用于衡量流行病学研究中的暴露和结果，因此需要良好的有效性。随着癌症幸存者数量的增加，人们对治疗相关并发症的持续评估产生了兴趣，使用自填问卷对患者报告的骨髓移植（BMT）并发症的医疗记录进行了验证。研究人群包括 100 名在希望之城接受过 BMT 的患者。使用病历验证了以下自我报告的并发症：眼部、内分泌、心血管、肌肉骨骼、肺部、胃肠道、神经、移植物抗宿主病和随后的癌症。使用病历信息作为标准，敏感性范围为后续癌症的 52.9% 到股骨头坏死和甲状腺功能减退症的 100%，特异性范围为眼部并发症的 75.4% 到股骨头坏死的 100%，所有评估的并发症具有中等至极好的一致性（kappa = 0.4-1.0）。因此，自我报告和医疗记录之间的一致性对于具有明确诊断标准且易于传达给患者的并发症有好处，但对于未确定的诊断标准（干眼症）或波动性病程（周围神经病变和高血压）的并发症则较差。总体而言，这些结果表明癌症幸存者可以在流行病学研究中以可接受的准确性水平自我报告严重并发症。
Self-administered questionnaires are commonly used to measure exposures and outcomes in epidemiological research and thus need good validity. With increasing numbers of cancer survivors, there is interest in the ongoing assessment of therapy-related complications, A medical record validation of patient-reported complications following bone marrow transplantation (BMT) was performed using a self-administered questionnaire. The study population consisted of 100 patients who had undergone BMT at the City of Hope. The following self-reported complications were validated using medical records: ocular, endocrine, cardiovascular, musculoskeletal, pulmonary, gastrointestinal, neurological, graft-versus-host disease, and subsequent cancers. Using information from medical records as the standard, sensitivities ranged from 52.9% for subsequent cancers to 100% for avascular necrosis and hypothyroidism, Specificities ranged from 75.4% for ocular complications to 100% for avascular necrosis, There was intermediate to excellent agreement (kappa = 0.4-1.0) for all complications evaluated. Thus, the agreement between self-reporting and medical records was good for complications with clear diagnostic criteria that are easily communicated to the patient, but was diminished for complications with non-established diagnostic criteria (xerophthalmia) or a fluctuating course (peripheral neuropathies and hypertension), Overall these results suggest that cancer survivors can self-report serious complications with an acceptable level of accuracy in epidemiological research.