title: Comparison of Patient Report and Medical Records of Comorbidities: Results From a Population-Based Cohort of Patients With Prostate Cancer.
abstract: OBJECTIVE
  The comorbid conditions of patients with cancer affect treatment decisions, which in turn affect survival and health-related quality-of-life outcomes. Comparative effectiveness research studies must account for these conditions via medical record abstraction or patient report.
  
  
  OBJECTIVE
  To examine the agreement between medical records and patient reports in assessing comorbidities.
  
  
  METHODS
  Patient-reported information and medical records were prospectively collected as part of the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study, a population-based cohort of 881 patients with newly diagnosed localized prostate cancer enrolled in the North Carolina Central Cancer Registry from January 1, 2011, through June 30, 2013. The presence or absence of 20 medical conditions was compared based on patient report vs abstraction of medical records.
  
  
  METHODS
  Agreement between patient reports and medical records for each condition was assessed using the κ statistic. Subgroup analyses examined differences in κ statistics based on age, race, marital status, educational level, and income. Logistic regression models for each condition examined factors associated with higher agreement.
  
  
  RESULTS
  A total of 881 patients participated in the study (median age, 65 years; age range, 41-80 years; 633 white [71.9%]). In 16 of 20 conditions, there was agreement between patient reports and medical records for more than 90% of patients; agreement was lowest for hyperlipidemia (68%; κ = 0.36) and arthritis (66%; κ = 0.14). On multivariable analysis, older age (≥70 years old) was significantly associated with lower agreement for myocardial infarction (odds ratio [OR], 0.31; 95% CI, 0.12-0.80), cerebrovascular disease (OR, 0.10; 95% CI, 0.01-0.78), coronary artery disease (OR, 0.37; 95% CI, 0.20-0.67), arrhythmia (OR, 0.44; 95% CI, 0.25-0.79), and kidney disease (OR, 0.18; 95% CI, 0.06-0.52). Race and educational level were not significantly associated with κ in 18 of 19 modeled conditions.
  
  
  CONCLUSIONS
  Overall, patient reporting provides information similar to medical record abstraction without significant differences by patient race or educational level. Use of patient reports, which are less costly than medical record audits, is a reasonable approach for observational comparative effectiveness research.
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Fan
authors.initials: F
authors.lastname: Ye
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Dominic H
authors.initials: DH
authors.lastname: Moon
authors.affiliation: Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill.|Department of Health Policy and Management, the University of North Carolina at Chapel Hill, Chapel Hill.|Cecil G. Sheps Center for Health Services Research, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.affiliation: Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill.|Department of Health Policy and Management, the University of North Carolina at Chapel Hill, Chapel Hill.|Cecil G. Sheps Center for Health Services Research, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Bryce B
authors.initials: BB
authors.lastname: Reeve
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Usinger
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Green
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Kiayni
authors.initials: K
authors.lastname: Spearman
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Sheets
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Pearlstein
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Angela R
authors.initials: AR
authors.lastname: Lucero
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Waddle
authors.affiliation: Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Godley
authors.affiliation: Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.|Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D057186:Comparative Effectiveness Research; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D044469:Racial Groups; D057566:Self Report; D012959:Socioeconomic Factors