Comparison of patient report and medical records of comorbidities: Results from a population-based cohort of patients with prostate cancer
Menées aux Etats-Unis, ces deux études évaluent, d'une part, la faisabilité et l'intérêt d'un système permettant aux patients de rapporter les événements indésirables liés aux traitements dans le cadre d'essais cliniques et, d'autre part, la concordance entre les données rapportées par les patients eux-mêmes sur les comorbidités et celles contenues dans les dossiers médicaux
Importance : The comorbid conditions of patients with cancer affect treatment decisions, which in turn affect survival and health-related quality-of-life outcomes. Comparative effectiveness research studies must account for these conditions via medical record abstraction or patient report.
Objective : To examine the agreement between medical records and patient reports in assessing comorbidities.
Design, Setting, and Participants : Patient-reported information and medical records were prospectively collected as part of the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study, a population-based cohort of 881 patients with newly diagnosed localized prostate cancer enrolled in the North Carolina Central Cancer Registry from January 1, 2011, through June 30, 2013. The presence or absence of 20 medical conditions was compared based on patient report vs abstraction of medical records.
Main Outcomes and Measures : Agreement between patient reports and medical records for each condition was assessed using the
κ statistic. Subgroup analyses examined differences in κ statistics based on age, race, marital status, educational level, and income. Logistic regression models for each condition examined factors associated with higher agreement.
Results
:
A total of 881 patients participated in the study (median age, 65 years; age range, 41-80 years; 633 white [71.9%]). In 16 of 20 conditions, there was agreement between patient reports and medical records for more than 90% of patients; agreement was lowest for hyperlipidemia (68%; κ
= 0.36) and arthritis (66%;
κ
= 0.14). On multivariable analysis, older age (≥70 years old) was significantly associated with lower agreement for myocardial infarction (odds ratio [OR], 0.31; 95% CI, 0.12-0.80), cerebrovascular disease (OR, 0.10; 95% CI, 0.01-0.78), coronary artery disease (OR, 0.37; 95% CI, 0.20-0.67), arrhythmia (OR, 0.44; 95% CI, 0.25-0.79), and kidney disease (OR, 0.18; 95% CI, 0.06-0.52). Race and educational level were not significantly associated with
κ in 18 of 19 modeled conditions.
JAMA Oncology , résumé, 2016