Assessment of accuracy of data obtained from patient-reported questionnaire (PRQ) compared to electronic patient records (EPR) in patients with lung cancer.

Abstract

40 Background: Cigarette smoking, alcohol consumption and co-morbidities are important determinants of health in lung cancer patients. The gold standard for obtaining accurate data is PRQ. The purpose of this study is to ascertain the accuracy of abstracting health-related behaviour data from retrospective chart review compared to data directly obtained from PRQ in a lung cancer patient population. Methods: 731 lung cancer patients completed a PRQ related to lifetime tobacco use, alcohol consumption and co-morbidity. Relevant smoking, alcohol and co-morbidity data was collected independently from EPR. Results: Ever/never status for smoking showed almost perfect agreement (k=0.95) between PRQ and EPR and surpassed all other health behavioural measures and co-morbidity agreement values. Both the sensitivity and specificity were high (0.94 and 0.99 respectively). The calculation of pack-years from EPR and PRQ showed substantial agreement (k=0.77); However, categorizing the smoking status into current/ former / never, resulted in moderate agreement (k=0.46). Alcohol ever/ never status agreement was moderate (0.43) with high sensitivity (0.90) but low specificity (0.50). Agreement for co-morbidities varied by condition showing moderate to substantial agreement for hypertension (K=0.57), heart attack (K=0.80) and diabetes (K=0.76) while fair to slight agreement (K<0.4) was seen in the others. Specificity was 0.86 or higher for co-morbidity conditions and was consistently higher than the sensitivity. Conclusions: EPR may be used as a reliable surrogate to PRQ in determining ever/never smoking status and lifetime smoking exposure. Evaluation of current/former/never smoking status and alcohol consumption is best determined by PRQ. Diabetes, hypertension and heart attack are more accurately reported in the PRQ than other co-morbidities. Patients tend to report absence of a medical condition more accurately than the presence of it. Missing EPR data related to smoking pack years, alcohol consumption and lung co-morbidities is concerning and suggests more synoptic reporting by physicians would improve opportunities for research.

Enhanced access to healthcare utilization data through medical record review: Lessons learned from a community‐based, multi‐site project

“…Electronic health record (EHR) and medical claims databases are efficient sources for obtaining HCU data for health research (Bailey et al, 2016). Self‐report, claims data, hardcopy medical charts, and EHR sources offer both advantages and disadvantages regarding efficiency, cost, and accuracy of HCU data, which often necessitates accessing a combination of these sources to improve accuracy (De‐loyde et al, 2015; Hufford & Shiffman, 2002; Palepu et al, 2013; Voaklander et al, 2006). The literature related to conducting retrospective chart reviews as a research method is readily available (Franklin et al, 2017; Vassar & Holzmann, 2013).…”

Concordance between self-report and medical records of preventive healthcare delivery among a sample of disadvantaged patients from four aboriginal community controlled health services

“…Self-report can sometimes be less costly and more convenient than extracting data from medical record review [6]. Medical records can also have variable accuracy as a measure of healthcare delivery, with missing data a particular concern [9]. Despite no single validated measure (patient recall, provider recall or medical record audit) having a high and consistent level of accuracy, these measures are often used as indicators of healthcare delivery or service performance for quality improvement and other purposes [10].…”