A comparison of self-report and chart audit in studying resident physician assessment of cardiac risk factors.
OBJECTIVE
To examine the relationship between resident physicians' perceptions of their preventive cardiology practices and a chart audit assessment of their documented services.


METHODS
A criterion standard comparison of two methods used to assess resident physicians' practices: self-report and chart audit.


METHODS
Physician ambulatory care in a residency program.


METHODS
Coronary artery disease (CAD) risk factor assessment was evaluated by self-report for 72 resident physicians and by chart audit of randomly selected records of 544 of their patients who did not have CAD or a debilitating chronic disease during a one-year period.


METHODS
Measurements of the residents' perceived CAD risk factor assessment practice by self-report, and chart audit assessments of their recorded care.


RESULTS
The relationship between self-reported and chart audit assessments of CAD risk factors.


RESULTS
Chart audit assessment of CAD risk factor management was highly significantly (p < 0.01) lower than self-reported behaviors for evaluation of cigarette smoking, diet, physical activity, stress, plasma cholesterol, blood pressure, and body weight/obesity.


CONCLUSIONS
Three different interpretations of these findings are apparent. 1) Physician self-report is a poor tool for the measurement of clinical behavior, and therefore research of physician behavior should not rely solely on self-reported data; 2) physicians' chart recording of their clinical practice is insufficient to reflect actual care; or 3) neither is an accurate measure of actual practice.
Leaf
D A
DA
Department of Medicine, West Los Angeles VA Medical Center, CA 90073, USA.
Neighbor
W E
WE
Schaad
D
D
Scott
C S
CS
D002983:Clinical Competence; D003327:Coronary Disease / Q000175:diagnosis*; D006801:Humans; D007396:Internship and Residency; D008485:Medical Audit; D012307:Risk Factors; D012650:Self Disclosure