Shotorbani Solmaz, Miller Leslie, Blough David K, Gardner Jacqueline
Department of Pharmacy, The University of Washington, Box 357630, Seattle, WA 98195, USA.
Contraception. 2006 May;73(5):501-6. doi: 10.1016/j.contraception.2005.12.001. Epub 2006 Mar 20.
To measure agreement between women's self-administered risk factor questionnaire and their providers' evaluation of their medical eligibility for hormonal contraceptive use.
This was an anonymous cross-sectional study. Participants were women 15-45 years old who completed a 20-item self-administered questionnaire. Women were recruited from six public health family planning clinics in the Seattle Metropolitan area. A matching medical evaluation questionnaire was completed concurrently by each participant's health care provider. Using provider evaluation as the "gold standard" against which we compared self-reported medical history, we calculated participant-provider agreement with point estimates and 95% confidence interval (CI).
Of 399 participant and provider pairs, participant-provider agreement was obtained for 392 participant pairs. The majority of the participants (90.3%) were 15-30 years old and 77.7% had used a hormonal contraceptive method for more than 1 year. The estimated proportion of the overall agreement was 96% (95% CI, 0.92-0.98). Women were more likely to report severe headaches (12.4% vs. 3.3%), possible pregnancy (7.3% vs. 3.5%) and smoking (6.2% vs. 2.1%) than providers, but less likely to report smoking more than 15 cigarettes per day (2.6% vs. 9.2%) and irregular menses (6.5% vs. 9.9%).
Overall, a high proportion of the women in this study completed our medical history questionnaire in concordance with their health care providers' same-day medical evaluation. Agreement on critical medical eligibility criteria such as hypertension was well above 90%. For criteria on which there was disagreement, women were more likely to identify contraindications than were their providers.
衡量女性自行填写的风险因素问卷与医疗服务提供者对其使用激素避孕药物的医学适宜性评估之间的一致性。
这是一项匿名横断面研究。参与者为15至45岁的女性，她们完成了一份包含20个条目的自填问卷。这些女性是从西雅图都会区的六家公共卫生计划生育诊所招募而来的。每位参与者的医疗服务提供者同时完成一份匹配的医学评估问卷。以医疗服务提供者的评估作为“金标准”，并据此比较自我报告的病史，我们计算了参与者与医疗服务提供者之间的一致性，并给出点估计值和95%置信区间（CI）。
在399对参与者与医疗服务提供者中，有392对参与者达成了一致。大多数参与者（90.3%）年龄在15至30岁之间，77.7%的人使用激素避孕方法超过1年。总体一致性的估计比例为96%（95%CI，0.92 - 0.98）。与医疗服务提供者相比，女性更有可能报告严重头痛（12.4%对3.3%）、可能怀孕（7.3%对3.5%）和吸烟（6.2%对2.1%），但报告每天吸烟超过15支（2.6%对9.2%）和月经不规律（6.5%对9.9%）的可能性较小。
总体而言，本研究中的大多数女性在填写病史问卷时与医疗服务提供者当天的医学评估结果一致。在诸如高血压等关键医学适宜性标准方面的一致性远高于90%。对于存在分歧的标准，女性比其医疗服务提供者更有可能识别出禁忌证。
