AGREEMENT BETWEEN MEDICAL RECORD DATA AND PATIENTS ACCOUNTS OF THEIR MEDICAL HISTORY AND TREATMENT FOR DYSPEPSIA

We examined agreement between data abstracted from medical records and interview data for patients with dyspepsia admitted to hospital for e ndoscopy, to determine the extent to which health records could be use d to validate self reports of dyspepsia and the management of this con dition. Results from the sample of 220 patients showed that there was poor agreement between data sources for information about duration of dyspepsia (k = 0.34) and previous barium meal examination (k = 0.34). Patients reported significantly longer dyspepsia histories (Wilcoxon s ign test Z = 4.13, p < 0.0001) and significantly more barium meals (si gn test Z = 8.43, P < 0.0001) than were documented in their records. T here was also disagreement between data sources regarding the number o f drugs taken before and after endoscopy (k = 0.28 and k = 0.31, respe ctively). Where there was disagreement for number of drugs there was n o significant difference in the direction of the disagreement. There w as moderate agreement regarding the name of pre-endoscopy medication ( k = 0.55) and substantial agreement for the name of medication used po st-endoscopy (k = 0.62). There was very poor agreement regarding diagn osis. The medical record was the gold standard for this information. C hoice of data source, medical records or self-reports, will in many in stances provide significantly different results and it is likely that this may also be true for other variables of interest to researchers. Thus in the case where no gold standards are available researchers nee d to consider carefully the implication of choice of data source on th eir results. (C) 1998 Elsevier Science Inc.