LA-SER, Paris, France.
Pharmacoepidemiol Drug Saf. 2013 Mar;22(3):278-85. doi: 10.1002/pds.3401. Epub 2013 Jan 14.
Patients' self-reported vaccine exposure (PS) may be subject to memory errors and other biases. Physicians' prescription records and other medical records (MR) do not capture noncompliance with vaccination. This study compared PS with MR for influenza, 23-valent pneumococcal, and human papillomavirus (HPV) vaccines.
The Pharmacoepidemiologic General Research Extension (PGRx) database uses a network of over 300 general practitioners across France, who systematically recruit an age- and sex-stratified sample of patients (≥ 14 years old), without reference to their diagnoses or prescriptions. Patients received a structured telephone interview, combined with an interview guide listing vaccines commonly given. Patients' self-reported vaccination in the 3 years before their recruitment was compared with medical records kept by the physician or the patient.
Concordance between PS and MR was assessed for 7613 patients for whom both sources of information were available. Agreement within 3 years before the recruitment date was substantial for influenza vaccines (prevalence and bias-adjusted kappa [PABAK] = 0.74, sensitivity PS relative to MR 81.5%) and high for 23-valent pneumococcal vaccines (PABAK = 0.98, sensitivity PS 49.6) and HPV vaccines (PABAK = 0.92, sensitivity PS 91.6). In adjusted analyses, agreement varied with sociodemographic and health-related factors, particularly for influenza and 23-valent pneumococcal vaccines.
The PGRx method for drug exposure assessment is a new tool in pharmacoepidemiology that shows substantial to high agreement between PS and MR for exposure to various vaccines. Our finding of high agreement between PS and MR for HPV vaccination status in young women is a significant addition to the literature.
患者自我报告的疫苗接种情况（PS）可能受到记忆错误和其他偏差的影响。医生的处方记录和其他医疗记录（MR）无法捕捉到疫苗接种的不依从情况。本研究比较了 PS 与流感、23 价肺炎球菌和人乳头瘤病毒（HPV）疫苗的 MR。
Pharmacoepidemiologic General Research Extension（PGRx）数据库使用了法国 300 多名全科医生组成的网络，这些医生系统地招募了年龄和性别分层的患者样本（≥14 岁），而不参考他们的诊断或处方。患者接受了结构化的电话访谈，并结合了一份列出常见疫苗的访谈指南。将患者在招募前 3 年的自我报告接种情况与医生或患者保留的医疗记录进行比较。
对于同时有两种信息来源的 7613 名患者，评估了 PS 与 MR 的一致性。在招募日期前 3 年内，流感疫苗的一致性较高（流行率和偏倚调整kappa[PABAK] = 0.74，PS 相对于 MR 的敏感性为 81.5%），23 价肺炎球菌疫苗（PABAK = 0.98，PS 敏感性为 49.6%）和 HPV 疫苗（PABAK = 0.92，PS 敏感性为 91.6%）的一致性很高。在调整分析中，一致性因社会人口统计学和健康相关因素而异，特别是流感和 23 价肺炎球菌疫苗。
PGRx 药物暴露评估方法是药物流行病学中的一种新工具，它显示 PS 与 MR 之间在各种疫苗暴露方面具有显著到高度的一致性。我们发现 PS 与 HPV 疫苗接种状况在年轻女性中的高度一致性是对文献的重要补充。
