Klabunde Carrie N, Reeve Bryce B, Harlan Linda C, Davis William W, Potosky Arnold L
Health Services and Economics Branch, Applied Research Program, Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland 20892-7344, USA.
Med Care. 2005 Apr;43(4):391-400. doi: 10.1097/01.mlr.0000156851.80900.d1.
Comorbidity is an important dimension of patient health status. However, limited attention has been given to assessing the reliability of patient-reported data on comorbid conditions.
We sought to evaluate the consistency of self-report of 12 comorbid conditions at 3 distinct time points and examine the sociodemographic, clinical, health status, and survey factors associated with reliability.
We undertook a longitudinal cohort analysis of survey and medical record abstract data obtained from a population-based sample of 3095 prostate cancer survivors.
Consistent and inconsistent response patterns were assessed using descriptive statistics and regression modeling.
More than half of the cohort demonstrated consistent responses to all comorbid condition questionnaire items. Arthritis had the highest (13%) and liver disease the lowest (1%) proportion of inconsistent responses. Older age, lower income, and poorer general and mental health status were significant predictors of inconsistent responses. Subset analyses of the 4 most prevalent comorbid conditions (ie, arthritis, diabetes, hypertension, and depression) showed that respondents who reported that they were limited by, or taking prescription medicine for, the condition were more likely to provide consistent responses than those neither limited nor taking medicine. Response consistencies of 92% or better were obtained for 11 of the 12 conditions.
Men with a relatively recent prostate cancer diagnosis are generally able to provide reliable reports of their concomitant health conditions. To increase the likelihood of obtaining reliable data, investigators should consider ascertaining condition severity and current medical management when querying subjects about comorbid conditions in surveys.
共病是患者健康状况的一个重要维度。然而,对于评估患者报告的共病状况数据的可靠性关注有限。
我们试图评估在3个不同时间点对12种共病状况进行自我报告的一致性,并研究与可靠性相关的社会人口学、临床、健康状况和调查因素。
我们对从3095名前列腺癌幸存者的人群样本中获得的调查和病历摘要数据进行了纵向队列分析。
使用描述性统计和回归模型评估一致和不一致的反应模式。
超过一半的队列对所有共病状况问卷项目都给出了一致的回答。关节炎的不一致回答比例最高(13%),肝病最低(1%)。年龄较大、收入较低以及总体和心理健康状况较差是不一致回答的重要预测因素。对4种最常见的共病状况(即关节炎、糖尿病、高血压和抑郁症)的子集分析表明,报告因该状况而受限或正在服用处方药的受访者比既未受限也未服药的受访者更有可能给出一致的回答。12种状况中有11种的回答一致性达到92%或更高。
近期被诊断为前列腺癌的男性通常能够可靠地报告其伴随的健康状况。为了提高获得可靠数据的可能性,研究人员在调查中询问受试者共病状况时,应考虑确定病情严重程度和当前的医疗管理情况。