Madlensky Lisa, McLaughlin John, Goel Vivek
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.
Cancer Epidemiol Biomarkers Prev. 2003 Jul;12(7):656-9.
The purpose of this study was to compare self-reports of colorectal cancer (CRC) screening by fecal occult blood test (FOBT), sigmoidoscopy, and colonoscopy with medical records in a multiprovider health care setting. Relatives of CRC patients residing in Ontario, Canada completed a questionnaire indicating whether or not they had ever had any CRC screening tests. Medical records from physician's offices and hospitals were compared with the self reports, and where possible, reasons were obtained for nonmatching reports. Medical records for colonoscopies were readily available from various sources, and self-reports of this procedure were very accurate (kappa statistic for agreement beyond chance = 0.87). For sigmoidoscopy and FOBT, the agreement was poorer (kappa = 0.29 and 0.32, respectively); however, there were difficulties in obtaining records for these two procedures. Sigmoidoscopy procedures that took place many years ago were difficult to document, and physician's offices were unable to provide FOBT reports in many cases. Self-reports of colonoscopy were very accurate in this population, whereas self-reports of sigmoidoscopy and FOBT are somewhat less accurate, although this is likely due to challenges in obtaining a confirmatory record rather than an overreporting of tests. In a multiprovider publicly insured health care setting such as Canada, using self-reported information is likely to provide sufficiently accurate information for colonoscopy, but for other CRC screening tests, there may be difficulty in obtaining true estimates of the frequencies of these procedures.
本研究的目的是在多机构医疗保健环境中,将粪便潜血试验(FOBT)、乙状结肠镜检查和结肠镜检查的结直肠癌(CRC)筛查自我报告与病历进行比较。居住在加拿大安大略省的CRC患者亲属完成了一份问卷,表明他们是否曾进行过任何CRC筛查测试。将医生办公室和医院的病历与自我报告进行比较,并在可能的情况下获取报告不匹配的原因。结肠镜检查的病历很容易从各种来源获得,并且该检查的自我报告非常准确(超出偶然一致的kappa统计量=0.87)。对于乙状结肠镜检查和FOBT,一致性较差(kappa分别为0.29和0.32);然而,获取这两种检查的记录存在困难。多年前进行的乙状结肠镜检查很难记录,并且在许多情况下医生办公室无法提供FOBT报告。在该人群中,结肠镜检查的自我报告非常准确,而乙状结肠镜检查和FOBT的自我报告则不太准确,尽管这可能是由于获取确认记录存在挑战,而非检查报告过多。在加拿大这样的多机构公共保险医疗保健环境中,使用自我报告的信息可能为结肠镜检查提供足够准确的信息,但对于其他CRC筛查测试,可能难以获得这些检查频率的真实估计值。