Self-report versus Medical Records for Assessing Cancer-Preventive Services Delivery
Self-report versus Medical Records for Assessing Cancer-Preventive Services Delivery
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DOI：
10.1158/1055-9965.epi-08-0177
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发表时间：
2008-11-01
影响因子：
3.8
通讯作者：
Crabtree, Benjamin F.
中科院分区：
文献类型：
--
作者：
Ferrante, Jeanne M.;Ohman-Strickland, Pamela;Crabtree, Benjamin F.
癌症预防行为的准确测量对于质量改进、研究和公共卫生监督非常重要。然而，研究结果不同，这取决于患者的自我报告或医疗记录是否被用作数据源。我们评估了患者自我报告与医疗记录在风险因素、癌症筛查和初级保健患者行为咨询方面的一致性。比较了来自新泽西25个初级保健诊所的742名患者的患者调查和医疗记录数据，这些患者在基线时参与了SCOPE（通过参与性增强支持结直肠癌结局），这是一项旨在改善初级保健诊所结直肠癌筛查的干预试验。敏感性、特异性和一致率描述一致性。风险因素（个人或家族癌症史、吸烟）、癌症筛查（乳腺癌、宫颈癌、结直肠癌、前列腺癌）和咨询（癌症筛查建议、饮食或减肥、锻炼、戒烟）的自我报告和医疗记录之间的差异。同意率从41%（戒烟咨询）到96%（个人癌症史）不等。癌症筛查的一致性范围从61%（巴氏涂片和前列腺特异性抗原）到83%（结肠直肠内窥镜检查），自我报告率高于医疗记录率。自我报告也更频繁地报告了咨询（83%的患者自我报告，34%的患者通过医疗记录进行戒烟咨询）。决定使用哪个数据源将取决于关注的结果，数据是否用于临床决策，性能跟踪或人群监测;资源的可用性;以及是否假阳性或假阴性更值得关注。（癌症流行病学生物标志物Prev 2008;17（11）：2987-94）
Accurate measurement of cancer-preventive behaviors is important for quality improvement, research studies, and public health surveillance. Findings differ, however, depending on whether patient self-report or medical records are used as the data source. We evaluated concordance between patient self-report and medical records on risk factors, cancer screening, and behavioral counseling among primary care patients. Data from patient surveys and medical records were compared from 742 patients in 25 New Jersey primary care practices participating at baseline in SCOPE (supporting colorectal cancer outcomes through participatory enhancements), an intervention trial to improve colorectal cancer screening in primary care offices. Sensitivity, specificity, and rates of agreement describe concordance. between self-report and medical records for risk factors (personal or family history of cancer, smoking), cancer screening (breast, cervical, colorectal, prostate), and counseling (cancer screening recommendations, diet or weight loss, exercise, smoking cessation). Rates of agreement ranged from 41% (smoking cessation counseling) to 96% (personal history of cancer). Cancer screening agreement ranged from 61% (Pap and prostate-specific antigen) to 83% (colorectal endoscopy) with self-report rates greater than medical record rates. Counseling was also reported more frequently by self-report (83% by patient self-report versus 34% by medical record for smoking cessation counseling). Deciding which data source to use will depend on the outcome of interest, whether the data is used for clinical decision making, performance tracking, or population surveillance; the availability of resources; and whether a false positive or a false negative is of more concern. (Cancer Epidemiol Biomarkers Prev 2008;17(11):2987-94)