title: Concordance of self- and program-reported rates of cardiac rehabilitation referral, enrollment and participation.
abstract: BACKGROUND
  Despite potential bias, researchers often rely on patient self-reported data of health care use. However, the validity and accuracy of self-reported data on cardiac rehabilitation (CR) use are unknown.
  
  
  OBJECTIVE
  To assess the concordance between patient self-report and site-verified CR referral, enrollment and participation.
  
  
  METHODS
  A consecutive sample of 661 coronary artery disease inpatients (mean [+/- SD] age 61.27+/-1.31 years; 157 women [23.8%]) treated at three acute care sites was recruited (75% response rate) as part of a larger study comparing automatic with usual referral methods. CR referral, enrollment (attendance at intake assessment) and participation (percentage of program attended) were discerned in a mailed survey nine months following discharge (n=506; 84.3% retention). A total of 24 CR sites were contacted for verification.
  
  
  RESULTS
  A total of 276 participants (54.5%) self-reported CR referral, and CR sites verified receipt of 262 referrals (51.8%) (Cohen's kappa 0.899). A total of 232 participants (45.8%) self-reported CR enrollment, with site-verification for 208 participants (41.1%) (Cohen's kappa 0.846). Self-reported data indicated that participants attended a mean of 81.78+/-25.84% of prescribed CR sessions, with CR sites reporting that participants completed 80.75+/-31.27% of the program (r=0.662; P<0.001). Equivalency testing revealed that the self-reported and site-verified rates of program participation were equivalent (z<1.96).
  
  
  CONCLUSIONS
  The almost perfect agreement between the self-reported and site-verified use of CR services suggests that self-administered items are highly valid in this population.
authors.affiliation: York University, Toronto, Canada.
authors.forename: Sheena
authors.initials: S
authors.lastname: Kayaniyil
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Leung
authors.forename: Neville
authors.initials: N
authors.lastname: Suskin
authors.forename: Donna E
authors.initials: DE
authors.lastname: Stewart
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace