title: Agreement between upper respiratory diagnoses from self-report questionnaires and medical records in an occupational health setting.
abstract: BACKGROUND
  The Fire Department of the City of New York World Trade Center Health Program (FDNY-WTCHP) monitors and treats WTC-related illnesses through regular physical exams, self-administered health questionnaires and treatment visits, as indicated.
  
  
  METHODS
  We measured positive and negative predictive values (PPV, NPV) of self-reported diagnoses of GERD and rhinosinusitis from the health questionnaires in relation to FDNY physician diagnoses from the medical record.
  
  
  RESULTS
  Self-reported GERD had PPV and NPV of 54.0% and 95.7%, respectively; for rhinosinusitis, the PPV and NPV were 48.2% and 91.9%. These characteristics improved considerably (PPV 78.0% GERD and PPV 76.5% rhinosinusitis) in a subpopulation receiving medications from the FDNY-WTCHP.
  
  
  CONCLUSIONS
  The PPV of self-reported diagnoses demonstrates only modest value in predicting physician diagnoses, although high NPVs suggest benefit in ruling out disease. In subgroups selected for their higher disease prevalence, self-reported diagnoses may be considerably more useful.
authors.affiliation: Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York.
authors.forename: Jessica
authors.initials: J
authors.lastname: Weakley
authors.forename: Mayris P
authors.initials: MP
authors.lastname: Webber
authors.forename: Fen
authors.initials: F
authors.lastname: Ye
authors.forename: Rachel
authors.initials: R
authors.lastname: Zeig-Owens
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Charles B
authors.initials: CB
authors.lastname: Hall
authors.forename: Kerry
authors.initials: K
authors.lastname: Kelly
authors.forename: David J
authors.initials: DJ
authors.lastname: Prezant
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D060731:Emergency Responders; D005260:Female; D061388:Firefighters; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009519:New York City; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D011159:Population Surveillance; D011237:Predictive Value of Tests; D012220:Rhinitis / Q000175:diagnosis* / Q000209:etiology; D057566:Self Report; D047851:September 11 Terrorist Attacks; D012852:Sinusitis / Q000175:diagnosis* / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: GERD; World Trade Center; firefighters and EMS; medical records; negative predictive values; positive predictive values; rhinosinusitis; self-report