Comparison of self-reported initial treatment with medical records: Results from the prostate cancer outcomes study
Comparison of self-reported initial treatment with medical records: Results from the prostate cancer outcomes study
复制标题
DOI：
10.1093/aje/154.6.582
复制
发表时间：
2001-09-15
影响因子：
5
通讯作者：
Hamilton, AS
中科院分区：
文献类型：
--
作者：
Clegg, LX;Potosky, AL;Hamilton, AS
医疗记录通常被认为是记录癌症治疗的最准确的信息来源。然而，随着医疗保健系统变得更加分散，更多的癌症护理是在门诊提供的，它是越来越困难和昂贵的审查记录，从许多外科医生和医疗/放射肿瘤学家谁管理癌症治疗在社区设置。使用1994-1995年的数据，作者比较了3,196名美国男性在基于人群的前列腺癌结局研究中自我报告的前列腺癌初始治疗（通过邮寄问卷或电话/面对面访谈）与从医疗记录中获得的信息。自我报告和医疗记录之间的协议因治疗类型而异。一般来说，对于更具侵入性的手术，如乳房切除术或放疗，一致性非常好（Kappa值> 0.8），而对于激素注射和药丸，一致性降低（Kappa值< 0.7）。如果将病历摘要假设为“金标准”，则估计的灵敏度对于直肠癌切除术和放射治疗通常较高（>80%），而对于激素药丸则较低（68%），尽管估计的特异性对于所有治疗均为90%或更高。这些结果可以作为一个有用的指导研究人员考虑使用调查作为替代病历摘要，以确定治疗的患者结果的研究。
Medical records are generally accepted as the most accurate source of information documenting cancer treatments. However, as the health care system becomes more decentralized and more cancer care is delivered in outpatient settings, it is increasingly difficult and expensive to review records from the many surgeons and medical/radiation oncologists who administer cancer therapies in the community setting. Using 1994-1995 data, the authors compared initial treatment for prostate cancer self-reported (from a mailed questionnaire or telephone/in-person interview) by 3,196 US men in the population-based Prostate Cancer Outcomes Study with information obtained from medical records. Agreement between self-reports and medical records varied by type of treatment. Generally, agreement was excellent for more invasive procedures such as prostatectomy or radiation (kappa values > 0.8), with decreasing agreement for hormone shots and pills (kappa values < 0.7). If the medical record abstract is assumed to be the "gold standard," the estimated sensitivity was generally high (>80%) for prostatectomy and radiation but low (68%) for hormone pills, although the estimated specificity was 90% or greater for all treatments. These results can serve as a useful guide to researchers contemplating the use of surveys as an alternative to medical record abstraction to ascertain treatment in studies of patient outcomes.