Author(s): Malik AS, Giamouzis G, Georgiopoulou VV, Fike LV, Kalogeropoulos AP, , Malik AS, Giamouzis G, Georgiopoulou VV, Fike LV, Kalogeropoulos AP,
Abstract Share this page
Abstract A shared understanding of medical conditions between patients and their health care providers may improve self-care and outcomes. In this study, the concordance between responses to a medical history self-report (MHSR) form and the corresponding provider documentation in electronic health records (EHRs) of 19 select co-morbidities and habits in 230 patients with heart failure were evaluated. Overall concordance was assessed using the κ statistic, and crude, positive, and negative agreement were determined for each condition. Concordance between MHSR and EHR varied widely for cardiovascular conditions (κ = 0.37 to 0.96), noncardiovascular conditions (κ = 0.06 to 1.00), and habits (κ = 0.26 to 0.69). Less than 80\% crude agreement was seen for history of arrhythmias (72\%), dyslipidemia (74\%), and hypertension (79\%) among cardiovascular conditions and lung disease (70\%) and peripheral arterial disease (78\%) for noncardiovascular conditions. Perfect agreement was observed for only 1 of the 19 conditions (human immunodeficiency virus status). Negative agreement >80\% was more frequent than >80\% positive agreement for a condition (15 of 19 [79\%] vs 8 of 19 [42\%], respectively, p = 0.02). Only 20\% of patients had concordant MSHRs and EHRs for all 7 cardiovascular conditions; in 40\% of patients, concordance was observed for ≤5 conditions. For noncardiovascular conditions, only 28\% of MSHR-EHR pairs agreed for all 9 conditions; 37\% agreed for ≤7 conditions. Cumulatively, 39\% of the pairs matched for ≤15 of 19 conditions. In conclusion, there is significant variation in the perceptions of patients with heart failure compared to providers' records of co-morbidities and habits. The root causes of this variation and its impact on outcomes need further study. Copyright © 2011 Elsevier Inc. All rights reserved.
This article was published in Am J Cardiol
and referenced in Biological Systems: Open Access