title: Which information source is best? Concordance between patient report, clinician report and medical records of patient co-morbidity and adjuvant therapy health information.
abstract: Previous studies investigating agreement between data sources for co-morbidity and adjuvant therapy information have suggested agreement varies depending on how the information is collected. The aim of this study was to compare agreement among three data sources: patient report, clinician report and medical record.
  
  
  METHODS
  Data were collected as part of a nurse-delivered telephone intervention (the CONNECT programme). Patient report was collected using a self-administered questionnaire. Clinician report was collected from the patient's treating surgeon. Medical record information was extracted by a member of the research team. The proportion of specific agreement [positive (PA) and negative agreement (NA)] and Kappa statistics were calculated.
  
  
  RESULTS
  The study sample comprised 756 surgical patients with colorectal cancer. For the majority of co-morbidities the lowest level of agreement was found between the patient and clinician (PA 0.29-0.64, Kappa values ranged from 0.22 to 0.58). The highest agreement and Kappa values for co-morbidities were generally found between the patient report and medical record (PA 0.36-0.80 and NA 0.92-0.99; Kappa 0.34-0.77). There was good agreement between patient and clinician reports for receipt adjuvant therapy {Kappa 0.78 [confidence interval (CI) 0.72-0.84] and 0.84 [CI 0.80-0.88], respectively; PA 0.87 and 0.92, respectively}. No consistent pattern in the predictors of non-agreement was found.
  
  
  CONCLUSIONS
  Given there was higher agreement between patient report and medical record review, the use of patient self-report questionnaires to ascertain co-morbid conditions remains a valid method for health services research.
authors: Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors: Katie J
authors: KJ
authors: De-loyde
authors: James D
authors: JD
authors: Harrison
authors: Ivana
authors: I
authors: Durcinoska
authors: Heather L
authors: HL
authors: Shepherd
authors: Michael J
authors: MJ
authors: Solomon
authors: Jane M
authors: JM
authors: Young
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods*; D015897:Comorbidity; D003625:Data Collection / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009726:Nurses; D057566:Self Report; D012959:Socioeconomic Factors
keywords: adjuvant therapy data; agreement between sources; clinician report; co-morbidity data; concordance; patient self-report