Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany.
J Public Health (Oxf). 2010 Sep;32(3):387-94. doi: 10.1093/pubmed/fdq013. Epub 2010 Mar 5.
To determine the accuracy of patient self-reports of specific cardiovascular diagnoses and to identify individual patient characteristics that influence the accuracy.
This investigation was conducted as a part of the randomized controlled ORBITAL study. Patients with hypercholesterolemia were enrolled in 1961 primary-care centers all over Germany. Self-reported questionnaire data of 7640 patients were compared with patients' case report forms (CRFs) and medical records on cardiovascular diseases, using kappa statistics and binomial logit models.
kappa values ranged from 0.89 for diabetes to 0.04 for angina. The percentage of overreporting varied from 1% for diabetes to 17% for angina, whereas the percentage of underreporting varied from 8.0% for myocardial infarction to 57% for heart failure. Individual characteristics such as choice of individual general practitioner, male gender and age were associated with the accuracy of self-report data.
Since the agreement between patient self-report and CRFs/medical records varies with specific cardiovascular diagnoses in patients with hypercholesterolemia, the adequacy of this tool seems to be limited. However, the authors recommend additional data validation for certain patient groups and consideration of individual patient characteristics associated with over- and underreporting.
为了确定患者对特定心血管诊断的自我报告的准确性，并确定影响准确性的个体患者特征。
本研究是作为随机对照 ORBITAL 研究的一部分进行的。在德国各地的 1961 个初级保健中心招募了高胆固醇血症患者。使用 Kappa 统计和二项逻辑回归模型，将 7640 名患者的自我报告问卷调查数据与患者的病例报告表（CRF）和心血管疾病的病历进行比较。
Kappa 值范围从糖尿病的 0.89 到心绞痛的 0.04。报告过多的百分比从糖尿病的 1%到心绞痛的 17%不等，而报告过少的百分比从心肌梗死的 8.0%到心力衰竭的 57%不等。个体特征，如个体全科医生的选择、男性性别和年龄，与自我报告数据的准确性相关。
由于高胆固醇血症患者的患者自我报告与 CRF/病历之间的一致性因特定心血管诊断而异，因此该工具的充分性似乎受到限制。然而，作者建议对某些患者群体进行额外的数据验证，并考虑与报告过多和过少相关的个体患者特征。
