title: The accuracy and trends of smoking history documentation in electronic medical records in a large managed care organization.
abstract: The accuracy of smoking history documentation in the electronic medical records was examined at a large managed care organization among 36,494 male members who self-reported smoking history in mailed surveys. The sensitivity of electronic smoking history documentation for ever-smoking status was 0.19 in years 2003-2005 (using ICD-9/CPT code only), 0.80 in 2006-2008 and 0.84 in 2009-2010 (combination of ICD-9/CPT codes and risk factor module used after 2006). The positive predictive value was 0.96, 0.90, and 0.95 in these periods, respectively. Among self-reported ever-smokers, increased healthcare utilization and smoking intensity/duration were associated with higher likelihood of having electronic smoking history documentation, while Asian race and Spanish language preference were associated with lower likelihood. These data suggest that enhanced efforts may be needed to screen for and document smoking among racial/ethnic minorities.
authors.affiliation: Kaiser Permanente Southern California, Research and Evaluation, Pasadena, California 91101, USA.
authors.forename: Lie-Hong
authors.initials: LH
authors.lastname: Chen
authors.forename: Virginia
authors.initials: V
authors.lastname: Quinn
authors.forename: Lanfang
authors.initials: L
authors.lastname: Xu
authors.forename: Michael K
authors.initials: MK
authors.lastname: Gould
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Corinna
authors.initials: C
authors.lastname: Koebnick
authors.forename: Kristi
authors.initials: K
authors.lastname: Reynolds
authors.forename: Rulin C
authors.initials: RC
authors.lastname: Hechter
authors.forename: Chun R
authors.initials: CR
authors.lastname: Chao
mesh_terms: D057286:Electronic Health Records; D005006:Ethnicity / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology*