Concordance between self-reports and archival records of physician visits: A case-control study comparing individuals with and without alcohol use disorders in the community
Concordance between self-reports and archival records of physician visits: A case-control study comparing individuals with and without alcohol use disorders in the community
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DOI：
10.1016/j.drugalcdep.2010.11.021
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发表时间：
2011-07-01
影响因子：
4.2
通讯作者：
Bucholz, Kathleen K.
中科院分区：
文献类型：
--
作者：
Glass, Joseph E.;Bucholz, Kathleen K.
目的：酒精使用障碍（AUD）患者自我报告的医疗保健使用的准确性受到质疑。本研究试图比较的准确性，自我报告的医生访问的个人谁不同，就他们的历史AUDs.Methods：我们的数据来源是一个14年的随访的个人在圣路易斯网站的1981-1983年流行病学集水区研究（ECA）。我们采用病例对照设计（n = 237），比较两个对照组（有问题/非常大量饮酒的患者（n = 81）和未受酒精影响的患者（n = 81））中稳定诊断为AUDs的ECA参与者（例; n = 75）自我报告的准确性。组内相关系数（ICC）描述了自我报告和过去六个月内医生就诊的档案记录之间的一致性。我们使用多项逻辑回归，以确定与低报和高报，零截断泊松回归，以确定与不一致severity.Results相关的特征：自我报告的情况下，与医生的记录有很大的一致性（ICC = 0.74，CI = 0.61-0.83）。与病例相比，那些有问题/非常大量饮酒的人的ICC显著较高，而那些不受酒精影响的人的ICC显著较低。然而，当使用回归模型调整已知影响自我报告医疗保健使用准确性的因素时，一致性差异消失。利用频率是一个很强的预测不准确reporting.Conclusions：这些研究结果表明AUD状态可能不会独立影响自我报告的准确性。当使用频率较低时，AUD患者的医生就诊次数可能被认为是准确的。(C)2010爱思唯尔爱尔兰有限公司版权所有。
Objective: The accuracy of self-reported healthcare use among individuals with alcohol use disorders (AUD) has been questioned. The present study attempts to compare the accuracy of self-reported physician visits for individuals who differ with respect to their history of AUDs.Methods: Our data source was a 14-year follow-up of individuals interviewed at the St. Louis site of the 1981-1983 Epidemiologic Catchment Area Study (ECA). We used a case-control design (n = 237) to compare the accuracy of self-reports among ECA participants with stably diagnosed AUDs (cases; n = 75) to two comparison groups: those with problem/very heavy drinking (n = 81) and those unaffected by alcohol (n = 81). Intraclass correlation coefficients (ICC) described the concordance between self-reports and archival records of physician visits in the prior six months. We used multinomial logistic regression to identify characteristics associated with under-reporting and over-reporting, and zero-truncated Poisson regression to identify characteristics associated with discordance severity.Results: Self-reports of cases had substantial concordance with physician records (ICC = 0.74, Cl = 0.61-0.83). As compared to cases, those with problem/very heavy drinking had a significantly higher ICC, and those who were unaffected by alcohol had a significantly lower ICC. However, differences in concordance disappeared when using regression models that adjusted for factors known to affect the accuracy of self-reported healthcare use. Utilization frequency was a strong predictor of inaccurate reporting.Conclusions: These findings suggest AUD status may not independently affect the accuracy of self-reports. Counts of physician visits for those with AUD may be considered accurate when utilization frequency is low. (C) 2010 Elsevier Ireland Ltd. All rights reserved.