糖尿病自我报告与医疗记录的一致性:新加坡综合诊所数据的比较研究。

IF 5.2 4区 医学 Q2 Medicine
Annals Academy of Medicine Singapore Pub Date : 2023-02-01
Khai Wei Tan, Jeremy Kaiwei Lew, Poay Sian Sabrina Lee, Sin Kee Ong, Hui Li Koh, Doris Yee Ling Young, Eng Sing Lee
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引用次数: 0

摘要

在流行病学研究中,通常对患者疾病自述与标准(如图表审查)之间的一致性进行研究,以评估用于公共卫生研究的自述数据的一致性。据我们所知,目前还没有关于高流行慢性病如糖尿病和前驱糖尿病的一致性的发表研究。本研究的目的是评估患者自我报告与糖尿病和糖尿病前期诊断之间的一致性,并确定糖尿病一致性的相关因素。方法:在征得慢性病患者书面同意后,采用横断面访谈法对其病历进行评估。面试官对参与者的个人资料一无所知。采用Cohen’s kappa (κ)评价一致性。采用多变量logistic回归模型确定与糖尿病一致性相关的因素。结果:自述与病历对糖尿病诊断的一致性较好(κ=0.76),糖尿病前期诊断的一致性较好(κ=0.36)。logistic回归模型显示,非中国籍患者糖尿病一致性的发生率高于中国籍患者(优势比[OR]=4.10, 95%可信区间[CI] 1.19 ~ 14.13, P=0.03)。患有3种或3种以上慢性病(即多重发病)的患者与无多重发病的患者相比,糖尿病一致性的发生率较低(or =0.21, 95% CI 0.09-0.48, p)。结论:糖尿病一致性是显著的,支持慢性病患者在初级保健环境中使用糖尿病自我报告,用于未来的研究。糖尿病前期的一致性是公平的,可能具有重要的临床意义。需要进一步的研究来探索和提高健康素养和医患沟通。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Concordance of self-reporting of diabetes compared with medical records: A comparative study using polyclinic data in Singapore.

Introduction: Studies of concordance between patients' self-report of diseases and a criterion standard (e.g. chart review) are usually conducted in epidemiological studies to evaluate the agreement of self-reported data for use in public health research. To our knowledge, there are no published studies on concordance for highly prevalent chronic diseases such as diabetes and pre-diabetes. The aims of this study were to evaluate the concordance between patients' self-report and their medical records of diabetes and pre-diabetes diagnoses, and to identify factors associated with diabetes concordance.

Method: A cross-sectional, interviewer-administered survey was conducted on patients with chronic diseases after obtaining written consent to assess their medical notes. Interviewers were blinded to the participants' profiles. Concordance was evaluated using Cohen's kappa (κ). A multivariable logistic regression model was used to identify factors associated with diabetes concordance.

Results: There was substantial agreement between self-reported and medical records of diabetes diagnoses (κ=0.76) and fair agreement for pre-diabetes diagnoses (κ=0.36). The logistic regression model suggested that non-Chinese patients had higher odds of diabetes concordance than Chinese patients (odds ratio [OR]=4.10, 95% confidence interval [CI] 1.19-14.13, P=0.03). Patients with 3 or more chronic diseases (i.e. multimorbidity) had lower odds of diabetes concordance than patients without multimorbidity (OR=0.21, 95% CI 0.09-0.48, P<0.001).

Conclusion: Diabetes concordance was substantial, supporting the use of self-report of diabetes by patients with chronic diseases in the primary care setting for future research. Pre-diabetes concordance was fair and may have important clinical implications. Further studies to explore and improve health literacy and patient-physician communication are needed.

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来源期刊
Annals Academy of Medicine Singapore
Annals Academy of Medicine Singapore 医学-医学:内科
CiteScore
4.90
自引率
5.80%
发文量
186
审稿时长
6-12 weeks
期刊介绍: The Annals is the official journal of the Academy of Medicine, Singapore. Established in 1972, Annals is the leading medical journal in Singapore which aims to publish novel findings from clinical research as well as medical practices that can benefit the medical community.
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