ABSTRACT
OBJECTIVES: The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. METHODS: Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. RESULTS: Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of self-reported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. CONCLUSIONS: Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.
Subject(s)
Female , Humans , Bias , Comorbidity , Data Accuracy , Delivery of Health Care , Diabetes Mellitus , Dyslipidemias , Heart Diseases , Hypertension , Insurance , Logistic Models , Mass Screening , Sensitivity and Specificity , Stroke , Tuberculosis, PulmonaryABSTRACT
Dos mil cinco conductores, 1204 hombres y 801 mujeres, una muestra representativa de la población española de conductores, fueron nuevamente examinados utilizando un cuestionario que reproducía fielmente un examen de conducir realizado por la Dirección General de Tráfico (DGT). Las preguntas fueron clasificadas en "muy importantes", "importantes" y "poco importantes". El 96.5 % de los conductores, suspendió el examen. Los resultados eran tanto peores cuanto más tiempo había transcurrido desde la obtención del permiso de conducir. Esto era independiente de la importancia de las preguntas, de la mayor o menor frecuencia de conducción y afectaba por igual a hombres y mujeres. Las mujeres obtienen mejores puntuaciones en señalización mientras que los hombres son mejores en las preguntas de seguridad vial. Los resultados también demostraban que los conductores profesionales y los de mayor nivel educativo sufren un menor deterioro. Tales resultados nos llevan a considerar la relación que estos datos puedan tener en los niveles de accidentalidad y la conveniencia de establecer pautas para la actualización del conocimiento de los conductores. Finalmente, se discute la relevancia que el examen que se utiliza para obtener el permiso de conducir tiene como indicador o predictor de una futura conducción segura.
Two thousand and five drivers, 1204 men and 801 women, a representative sample of the Spanish drivers, were re-examined using a questionnaire that faithfully reproduced a driving test conducted by the Directorate General of Traffic (DGT). Items were classified as "very important", "important" and "unimportant." 96.5% of drivers did not pass the test. The results were much worse the more time had elapsed since obtaining the driving license. These results were independent of the importance of the items, the greater or lesser frequency of driving and applied equally to men and women. Women perform better signalling while men are better at questions of road safety. Results also showed that the loss of knowledge was lower in those drivers who had higher education training and professional drivers. The results lead us to consider the relationship that these data may have on levels of accidents and the desirability of establishing guidelines for updating the knowledge of the drivers. Finally, the relevance of the test used to obtain a driver's license as an indicator or predictor of safe driving is discussed.