Agreement between obstructive airways disease diagnoses from self-report questionnaires and medical records

Details

• Personal Author:
  Cohen HW ; Hall CB ; Kelly K ; Prezant DJ ; Weakley J ; Webber MP ; Ye F ; Zeig-Owens R
• Description:
  Objective: To evaluate agreement between self-reported obstructive airways disease (OAD) diagnoses of asthma, bronchitis, and chronic obstructive pulmonary disease (COPD)/emphysema obtained from the New York City Fire Department (FDNY) monitoring questionnaires with physician diagnoses from FDNY medical records. Method: We measured sensitivity, specificity, and agreement between self-report and physician OAD diagnoses in FDNY members enrolled in the World Trade Center (WTC) monitoring program who completed a questionnaire between 8/2005-1/2012. Using logistic models, we identified characteristics of those who self-report a physician diagnosis that is also reported by FDNY physicians. Results: 20.3% of the study population (N = 14,615) self-reported OAD, while 15.1% received FDNY physician OAD diagnoses. Self-reported asthma had the highest sensitivity (68.7%) and overall agreement (91.9%) between sources. Non-asthma OAD had the lowest sensitivity (32.1%). Multivariate analyses showed that among those with an OAD diagnosis from FDNY medical records, inhaler use (OR = 4.90, 95% CI = 3.84-6.26) and respiratory symptoms (OR = 1.55 [95% CI = 1.25-1.92]-1.77 [95% CI = 1.37-2.27]) were associated with self-reported OAD diagnoses. Conclusion: Among participants in the WTC monitoring program, sensitivity for self-reported OAD diagnoses ranges from good to poor and improves by considering inhaler use. These findings highlight the need for improved patient communication and education, especially for bronchitis or COPD/emphysema. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Delivery Of Health Care Diagnosis Emergencies Emergency Responders Health Care Facilities Workforce And Services Health Personnel Health Promotion Lung Diseases Occupational Health Respiratory Tract Diseases Safety Surveys And Questionnaires

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• Keywords:
  Airway-obstruction Author Keywords: Obstructive Airways Disease (OAD) Bronchial-asthma Clinical-diagnosis Emergency-responders Emergency-response Health-programs Health-surveys Lung-disorders Medical-care Medical-monitoring Physicians Population Study Pulmonary-system-disorders Questionnaires Rescue-workers Respiratory-system-disorders Self-reported Diagnoses Sensitivity-testing Sensitivity/Specificity/Agreement World Trade Center (WTC)

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• ISSN:
  0091-7435
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  38-42
• Volume:
  57
• Issue:
  1
• NIOSHTIC Number:
  nn:20043102
• Citation:
  Prev Med 2013 Jul; 57(1):38-42
• Contact Point Address:
  Mayris P. Webber, New York City Fire Department, Bureau of Health Services, 9 Metrotech Center, Brooklyn, NY 11201, USA
• Email:
  webberm@fdny.nyc.gov
• Federal Fiscal Year:
  2013
• Performing Organization:
  New York City Fire Department
• Peer Reviewed:
  True
• Start Date:
  20110701
• Source Full Name:
  Preventive Medicine
• End Date:
  20170331
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:610361b5f8cb906b034c87320a163d2ff9a2f817346fd11a91d1d1c9be78b7a8a12f3c0d580ca7c3b488f217073887bd6f749225b27a49bed178fddf0e14b225
• Download URL:
  https://stacks.cdc.gov/view/cdc/195115/cdc_195115_DS1.pdf
• File Type:
  [PDF - 218.81 KB ]