McKinney P A, Alexander F E, Nicholson C, Cartwright R A, Carrette J
Leukaemia Research Fund Centre for Clinical Epidemiology, Leeds.
J Public Health Med. 1991 Feb;13(1):13-22. doi: 10.1093/oxfordjournals.pubmed.a042571.
Mothers of 294 children aged 3-9 years were interviewed about their child's previous history of vaccinations and infections. The study group comprised healthy children selected at GP surgeries (n = 136) and those hospitalized for both minor and serious conditions (n = 168). The results evaluate the entire study group for the pattern of reporting vaccinations and infectious episodes under three years of age, comparing two different data sources-mothers' reports and GP records. Maternal recall accuracy is formally tested (Kappa statistic) for agreement with GP records. For vaccination history the results indicate that mothers and GPs are inadequate data sources, and suggest use of computerized health district records to improve data accuracy. Major differences on infectious history were evident for two types of questions-closed for specific infections and open-ended for 'other infections'. Specific infections (e.g. measles) were systematically over-reported by mothers compared with GP records, but mothers failed to 'time' the event. Concordance for 'other infections' was also poor, but, by contrast, GPs systematically over-recorded this range of infections, indicating substantial inaccuracy in mothers' recall. The authors suggest that GP records should be the preferred source of data for these 'other' infectious episodes, especially under one year of age. Improved questionnaire design would elicit more accurate maternal reports on specified infections for which a GP may well not be consulted and corroboration would be impossible.
对294名3至9岁儿童的母亲进行了访谈，询问她们孩子以前的疫苗接种和感染史。研究组包括在全科医生诊所挑选的健康儿童（n = 136）以及因轻症和重症住院的儿童（n = 168）。研究结果评估了整个研究组三岁以下疫苗接种和感染发作的报告模式，比较了两个不同的数据源——母亲的报告和全科医生的记录。通过卡方统计对母亲回忆的准确性与全科医生记录的一致性进行了正式测试。关于疫苗接种史，结果表明母亲和全科医生都不是足够的数据源，并建议使用计算机化的健康区记录来提高数据准确性。在两类问题上，感染史存在重大差异——关于特定感染的封闭式问题和关于“其他感染”的开放式问题。与全科医生记录相比，母亲系统性地过度报告了特定感染（如麻疹），但母亲没有准确说出感染时间。对于“其他感染”的一致性也很差，但相比之下，全科医生系统性地过度记录了这一系列感染，这表明母亲的回忆存在很大不准确。作者建议，对于这些“其他”感染发作，尤其是一岁以下儿童，全科医生记录应作为首选数据源。改进问卷设计将能获得关于特定感染更准确的母亲报告，而对于这些感染可能根本不会咨询全科医生，也无法进行核实。
