Jones Michael P, Bartrop Roger, Dickson Hugh G, Forcier Lina
Psychology Department, Macquarie University North Ryde, NSW, Australia.
Front Pharmacol. 2011 Apr 1;2:16. doi: 10.3389/fphar.2011.00016. eCollection 2011.
As part of a 10-year follow-up study of morbidity following spouse bereavement, concordance between subject reports of their illness experience and that given by their doctors' and other medical records has been assessed. Enumeration from medical records involved extensive and careful perusal of general practitioner, specialist, and hospital records while subject reports were aided by a structured questionnaire which helped to prompt subjects' memories. The findings showed generally poor concordance between these two sources of morbidity data. Overall only 22% of disease events were found in both sources: of the diseases that did not match 65% were from the record source and 35% were from the self-report source. Despite finding that concordance rates varied with some subject and disease factors, concordance was always less than might be expected to occur by random chance (the throw of a coin). These findings have serious implications for epidemiological and pharmacoeconomic research involving morbidity history as they suggest that neither the subject nor their medical record can generally be assumed to provide a complete enumeration of morbidity burden. Indeed, irrespective of the significant factors under consideration, the maximum concordance reached in this study was 45.7%.
作为一项关于配偶丧亲后发病情况的10年随访研究的一部分，研究人员评估了受试者对自身疾病经历的报告与医生及其他医疗记录所提供信息之间的一致性。从医疗记录中进行数据统计，需要广泛且仔细地查阅全科医生、专科医生和医院的记录，而受试者的报告则借助一份结构化问卷来辅助，该问卷有助于唤起受试者的记忆。研究结果显示，这两种发病数据来源之间的一致性总体较差。总体而言，在这两种来源中都发现的疾病事件仅占22%：在不匹配的疾病中，65%来自记录来源，35%来自自我报告来源。尽管发现一致性率会因一些受试者和疾病因素而有所不同，但一致性总是低于随机概率（抛硬币）可能出现的情况。这些发现对涉及发病史的流行病学和药物经济学研究具有严重影响，因为它们表明，一般而言，既不能假定受试者也不能假定其医疗记录能完整列举发病负担。事实上，无论考虑的显著因素如何，本研究中达到的最大一致性为45.7%。
