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- Title
Emergency department patient and physician survey accuracy compared to chart abstraction in patients with acute respiratory illness.
- Authors
Hunold, Katherine M.; Schwaderer, Andrew L.; Exline, Matthew; Hebert, Courtney; Lampert, Brent C.; Southerland, Lauren T.; Stephens, Julie A.; Boyer, Edward W.; Gure, Tanya R.; Mion, Lorraine C.; Hill, Michael; Chu, Ching‐Min B.; Ernie, Edriane; Caterino, Jeffrey M.
- Abstract
Background: High‐quality research studies in older adults are needed. Unfortunately, the accuracy of chart review data in older adult patients has been called into question by previous studies. Little is known on this topic in patients with suspected pneumonia, a disease with 500,000 annual older adult U.S. emergency department (ED) visits that presents a diagnostic challenge to ED physicians. The study objective was to compare direct interview and chart abstraction as data sources. Methods: We present a preplanned secondary analysis of a prospective, observational cohort of ED patients ≥65 years of age with suspected pneumonia in two Midwest EDs. We describe the agreement between chart review and a criterion standard of prospective direct patient survey (symptoms) or direct physician survey (examination findings). Data were collected by chart review and from the patient and treating physician by survey. Results: The larger study enrolled 135 older adults; 134 with complete symptom data and 129 with complete examination data were included in this analysis. Pneumonia symptoms (confusion, malaise, rapid breathing, any cough, new/worse cough, any sputum production, change to sputum) had agreement between patient/legally authorized representative survey and chart review ranging from 47.8% (malaise) to 80.6% (confusion). All examination findings (rales, rhonchi, wheeze) had percent agreement between physician survey and chart review of ≥80%. However, all kappas except wheezing were less than 0.60, indicating weak agreement. Conclusions: Both patient symptoms and examination findings demonstrated discrepancies between chart review and direct survey with larger discrepancies in symptoms reported. Researchers should consider these potential discrepancies during study design and data interpretation.
- Subjects
TREATMENT of respiratory diseases; PNEUMONIA treatment; COGNITION disorders; STATISTICS; HOSPITAL emergency services; SCIENTIFIC observation; SPUTUM; ACQUISITION of data; PHYSICIANS' attitudes; PATIENTS; PATIENTS' attitudes; CONTENT mining; SURVEYS; RESPIRATORY organ sounds; MEDICAL records; EMERGENCY medical services; COUGH; ACUTE diseases; SECONDARY analysis; LONGITUDINAL method; OLD age
- Publication
Academic Emergency Medicine, 2023, Vol 30, Issue 12, p1246
- ISSN
1069-6563
- Publication type
Article
- DOI
10.1111/acem.14810