Fried Lise E, Aschengrau Ann, Cabral Howard, Amaro Hortensia
Institute for Community Health, Instructor in Medicine, Harvard Medical School, 163 Gore Street, Cambridge, MA 02141, USA.
Matern Child Health J. 2006 Sep;10(5):451-60. doi: 10.1007/s10995-006-0108-9. Epub 2006 Jun 27.
This study investigated the agreement between self-reported and medical record assessment of exposure to violence and the impact of misclassification on the estimation of the association between exposure to violence and infant death and very low birthweight.
The study population consisted of women who participated in two case-control studies on infant death and very low birthweight. There were 254 pairs of interviews and medical record reviews available for comparison.
A total of 153 women (60.2%) reported ever being exposed to violence--92 (60.1%) based on the interview only, 18 (11.8%) based on the medical record only, and 43 (28.1%) in both sources. The sensitivity of the violence variables was low, ranging from 16.9% to 31.9% and kappa statistics showed poor agreement. Lower rates of all types of violence were found through the medical record than through the interview.
Prevalence of violence based on medical record alone had a high degree of misclassification and some odds ratios were biased toward the null. Studies in which violence is an exposure, outcome, or confounder must use participant interviews in order to gather accurate information. A combination of sources may be the most accurate.
本研究调查了暴力暴露的自我报告与病历评估之间的一致性，以及错误分类对暴力暴露与婴儿死亡和极低出生体重之间关联估计的影响。
研究人群包括参与两项关于婴儿死亡和极低出生体重的病例对照研究的女性。共有254对访谈和病历审查可供比较。
共有153名女性（60.2%）报告曾遭受暴力——仅基于访谈的有92名（60.1%），仅基于病历的有18名（11.8%），两种来源都有的有43名（28.1%）。暴力变量的敏感性较低，范围从16.9%到31.9%，kappa统计显示一致性较差。通过病历发现的各类暴力发生率低于通过访谈发现的。
仅基于病历的暴力发生率存在高度错误分类，一些比值比偏向于无效值。在暴力作为暴露因素、结局或混杂因素的研究中，必须采用参与者访谈以获取准确信息。多种来源结合可能是最准确的。
