The reliability and validity of doctor-recorded morbidity data in active data collection systems.
OBJECTIVE
To test the reliability and validity of morbidity data recorded by general practitioners (family physicians) on structured recording forms in active data collection systems.


METHODS
The consulting general practitioner recorded the problems managed at 347 video-taped doctor-patient contacts. Two observers independently viewed the video-tapes and completed a recording form for each. Problems were centrally coded, using the International Classification of Primary Care (ICPC).


METHODS
Primary health care.


METHODS
Overall distribution of the morbidity; positive agreement regarding the morbidity managed at matched contacts at three levels of specificity (chapter; chapter-component; specific rubric); agreement taking negative agreement into account using Cohen's Kappa.


RESULTS
Overall distribution of morbidity did not differ between observers. Positive mean agreement was 78.8% at chapter level, 69.6% at chapter-component, and 55.9% at rubric level. Kappa statistics showed agreement better than chance in all chapters, but failed to reach significance at rubric level in three chapters.


CONCLUSIONS
Morbidity data actively collected by GPs provide a reliable overview of morbidity managed in general practice. At a specific contact the morbidity recorded is reliable and valid at chapter level, and in most cases, at chapter-component level. At rubric level variance between practitioners in labelling the problem calls into question the validity and reliability of the data.
Britt
H
H
Department of General Practice, University of Sydney, NSW, Australia.
Angelis
M
M
Harris
E
E
D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods*; D005194:Family Practice / Q000706:statistics & numerical data*; D005568:Forms and Records Control / Q000706:statistics & numerical data*; D006801:Humans; D009017:Morbidity; D015588:Observer Variation; D015203:Reproducibility of Results