title: The exit interview as a proxy measure of malaria case management practice: sensitivity and specificity relative to direct observation.
abstract: BACKGROUND
  This paper aims to assess the sensitivity and specificity of exit interviews as a measure of malaria case management practice as compared to direct observation.
  
  
  METHODS
  The malaria case management of 1654 febrile patients attending 110 health facilities from across Papua New Guinea was directly observed by a trained research officer as part of a repeat cross sectional survey. Patient recall of 5 forms of clinical advice and 5 forms of clinical action were then assessed at service exit and statistical analyses on matched observation/exit interview data conducted.
  
  
  RESULTS
  The sensitivity of exit interviews with respect to clinical advice ranged from 36.2% to 96.4% and specificity from 53.5% to 98.6%. With respect to clinical actions, sensitivity of the exit interviews ranged from 83.9% to 98.3% and specificity from 70.6% to 98.1%.
  
  
  CONCLUSIONS
  The exit interview appears to be a valid measure of objective malaria case management practices such as the completion of a diagnostic test or the provision of antimalarial medication, but may be a less valid measure of low frequency, subjective practices such as the provision of malaria prevention advice.
authors.affiliation: Papua New Guinea Institute of Medical Research (PNGIMR), PO Box 60, Goroka, EHP 441, Papua New Guinea. justin.pulford@pngimr.org.pg.|School of Population Health, The University of Queensland, Herston, Qld 4006, Australia. justin.pulford@pngimr.org.pg.
authors.forename: Justin
authors.initials: J
authors.lastname: Pulford
authors.affiliation: Papua New Guinea Institute of Medical Research (PNGIMR), PO Box 60, Goroka, EHP 441, Papua New Guinea. peter.siba@pngimr.org.pg.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Siba
authors.affiliation: Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain. ivomueller@fastmail.fm.|Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia. ivomueller@fastmail.fm.
authors.forename: Ivo
authors.initials: I
authors.lastname: Mueller
authors.affiliation: Papua New Guinea Institute of Medical Research (PNGIMR), PO Box 60, Goroka, EHP 441, Papua New Guinea. manuel.hetzel@unibas.ch.|Swiss Tropical and Public Health Institute, PO Box, 4002, Basel, Switzerland. manuel.hetzel@unibas.ch.|University of Basel, Petersplatz 1, 4003, Basel, Switzerland. manuel.hetzel@unibas.ch.
authors.forename: Manuel W
authors.initials: MW
authors.lastname: Hetzel
mesh_terms: D000293:Adolescent; D000962:Antimalarials / Q000627:therapeutic use*; D019090:Case Management; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003955:Diagnostic Tests, Routine; D005260:Female; D006268:Health Facilities; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008288:Malaria / Q000188:drug therapy; D008297:Male; D011939:Mental Recall; D019370:Observation; D010219:Papua New Guinea; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000962:Antimalarials