The Value of Patient Self-report for Disease Surveillance |
| |
Authors: | Florence T Bourgeois Stephen C Porter Clarissa Valim Tiffany Jackson E Francis Cook Kenneth D Mandl |
| |
Institution: | 1. Department of Obstetrics & Gynecology, Boston Medical Center, 85 E. Concord St., Boston, MA 02118, United States of America;2. Department of Obstetrics & Gynecology, Thomas Jefferson University, 833 Chestnut St., Philadelphia, PA 19107, United States of America;3. Department of Obstetrics & Gynecology, St. Luke''s Hospital, 801 Ostrum St., Bethlehem, PA 18015, United States of America;4. Department of Psychiatry & Human Behavior, Thomas Jefferson University, 1233 Locust St. Suite 401, Philadelphia, PA 19107, United States of America |
| |
Abstract: | ObjectiveTo determine the accuracy of self-reported information from patients and families for use in a disease surveillance system.DesignPatients and their parents presenting to the emergency department (ED) waiting room of an urban, tertiary care children’s hospital were asked to use a Self-Report Tool, which consisted of a questionnaire asking questions related to the subjects’ current illness.MeasurementsThe sensitivity and specificity of three data sources for assigning patients to disease categories was measured: the ED chief complaint, physician diagnostic coding, and the completed Self-Report Tool. The gold standard metric for comparison was a medical record abstraction.ResultsA total of 936 subjects were enrolled. Compared to ED chief complaints, the Self-Report Tool was more than twice as sensitive in identifying respiratory illnesses (Rate ratio RR]: 2.10, 95% confidence interval CI] 1.81–2.44), and dermatological problems (RR: 2.23, 95% CI 1.56–3.17), as well as significantly more sensitive in detecting fever (RR: 1.90, 95% CI 1.67–2.17), gastrointestinal problems (RR: 1.10, 95% CI 1.00–1.20), and injuries (RR: 1.16, 95% CI 1.08–1.24). Sensitivities were also significantly higher when the Self-Report Tool performance was compared to diagnostic codes, with a sensitivity rate ratio of 4.42 (95% CI 3.45–5.68) for fever, 1.70 (95% CI 1.49–1.93) for respiratory problems, 1.15 (95% CI 1.04–1.27) for gastrointestinal problems, 2.02 (95% CI 1.42–2.87) for dermatologic problems, and 1.06 (95% CI 1.01–1.11) for injuries.ConclusionsDisease category assignment based on patient-reported information was significantly more sensitive in correctly identifying a disease category than data currently used by national and regional disease surveillance systems. |
| |
Keywords: | |
本文献已被 ScienceDirect 等数据库收录! |
|