Hopkins Linda M, Caughey Aaron B, Brown Jeanette S, Wassel Fyr Christina L, Creasman Jennifer M, Vittinghoff Eric, Van den Eeden Stephen K, Thom David H
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco CA.
Am J Obstet Gynecol. 2007 Mar;196(3):233.e1-6. doi: 10.1016/j.ajog.2006.10.899.
The purpose of this study was to determine the concordance of patient recall compared with chart abstraction for distant intrapartum variables and to evaluate predictors of concordance.
A random sample from a cohort of diverse women aged 40-74 years. Intrapartum variables reported by participants were compared with the medical record. Outcomes were assessed for sensitivity, specificity, positive predictive value, and negative predictive value. Multivariate logistic regression was used to determine predictors of concordance of patient recall.
Four hundred one births among 178 women were analyzed. Recall of cesarean delivery had the highest concordance (sensitivity, 0.98; specificity, 1.00; positive predictive value, 1.00; negative predictive value, 0.99). Laceration that required repair had the lowest concordance (sensitivity, 0.37; specificity, 0.68; positive predictive value, 0.34; negative predictive value, 0.81). No variables predicted concordance of recall for all variables.
The concordance of patient recall to chart abstraction for intrapartum variables varies widely, although with a pattern of greater specificity and negative predictive value of recall. This should be kept in mind during patient interviews and in the performance of clinical research.
本研究旨在确定患者回忆与病历摘要中关于分娩期远期变量的一致性，并评估一致性的预测因素。
从年龄在40 - 74岁的不同女性队列中随机抽样。将参与者报告的分娩期变量与病历进行比较。评估结果的敏感性、特异性、阳性预测值和阴性预测值。采用多变量逻辑回归确定患者回忆一致性的预测因素。
对178名女性的401次分娩进行了分析。剖宫产的回忆一致性最高（敏感性0.98；特异性1.00；阳性预测值1.00；阴性预测值0.99）。需要缝合的裂伤回忆一致性最低（敏感性0.37；特异性0.68；阳性预测值0.34；阴性预测值0.81）。没有变量能预测所有变量回忆的一致性。
患者回忆与病历摘要中分娩期变量的一致性差异很大，不过回忆的特异性和阴性预测值有更高的趋势。在患者访谈和临床研究实施过程中应牢记这一点。
