Blake Tamara L, Chang Anne B, Chatfield Mark D, Marchant Julie M, Petsky Helen L, McElrea Margaret S
Centre for Children's Health Research, Queensland University of Technology, Brisbane, Queensland, Australia.
Indigenous Respiratory Outreach Care Program, Prince Charles Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2020 Jan;56(1):55-60. doi: 10.1111/jpc.14490. Epub 2019 May 4.
Self-reporting and/or data from medical records are frequently used in studies to ascertain health history. Data on the discrepancies between these information sources is lacking for Indigenous Australians. This study reports such data for selected respiratory and atopic conditions common among Indigenous Australians.
Data were extracted from the Indigenous respiratory reference value study, a multicentre cross-sectional study of Indigenous children and young adults (3-25 years) between June 2015 and November 2017. Only those living in rural/remote regions were included. Self-reported history was collected from parents (if participants <18 years) or participants. Medical records were manually reviewed. Participants with incomplete data (missing self-reported and/or medical record information) were excluded. Agreement between sources was examined using Cohen's kappa.
Of 1097 participants, 889 (97.1% <18 years) had sufficient self-reported and medical record histories for comparison. Asthma was self-reported by 15.7% of participants and was reported in medical records for 10.3% (κ = 0.53, 95% confidence interval (CI) 0.45-0.61). For bronchiectasis, the reported rates were 1.5 and 0.7% (κ = 0.52, 95% CI 0.25-0.80), pneumonia 1.1 and 5.8% (κ = 0.15, 95% CI 0.02-0.27), allergic rhinitis 6.6 and 0.6% (κ = 0.05, 95% CI -0.03, 0.13) and eczema 5.8 and 6.2% (κ = 0.30, 95% CI 0.18-0.42).
Within our cohort, agreement was moderate for asthma and bronchiectasis, fair for eczema and poor for pneumonia and allergic rhinitis. These results highlight the challenges associated with how best to obtain an accurate health history within Australian Indigenous rural/remote communities. Generalisability of findings and contributions of poor health knowledge and/or poor medical record documentation need further exploration.
在研究中，自我报告和/或病历数据常用于确定健康史。澳大利亚原住民缺乏关于这些信息来源之间差异的数据。本研究报告了澳大利亚原住民中常见的特定呼吸道疾病和过敏性疾病的此类数据。
数据取自原住民呼吸参考值研究，这是一项针对2015年6月至2017年11月期间的原住民儿童和年轻人（3至25岁）的多中心横断面研究。仅纳入居住在农村/偏远地区的人群。自我报告的病史由父母（如果参与者<18岁）或参与者收集。对病历进行人工审查。排除数据不完整（缺少自我报告和/或病历信息）的参与者。使用科恩kappa检验来检查不同来源之间的一致性。
在1097名参与者中，889名（97.1%<18岁）有足够的自我报告病史和病历病史可供比较。15.7%的参与者自我报告患有哮喘，病历记录中报告的比例为10.3%（κ=0.53，95%置信区间（CI）0.45-0.61）。支气管扩张症的报告率分别为1.5%和0.7%（κ=0.52，95%CI 0.25-0.80），肺炎为1.1%和5.8%（κ=0.15，95%CI 0.02-0.27），过敏性鼻炎为6.6%和0.6%（κ=0.05，95%CI -0.03，0.13），湿疹为5.8%和6.2%（κ=0.30，95%CI 0.18-0.42）。
在我们的队列中，哮喘和支气管扩张症的一致性为中等，湿疹为尚可，肺炎和过敏性鼻炎为较差。这些结果凸显了在澳大利亚原住民农村/偏远社区中如何最好地获取准确健康史所面临的挑战。研究结果的普遍性以及健康知识匮乏和/或病历记录不完善的影响需要进一步探索。
