Patient perception versus medical record entry of health-related conditions among patients with heart failure

Adnan S. Malik, Grigorios Giamouzis, Vasiliki V. Georgiopoulou, Lucy V. Fike, Andreas P. Kalogeropoulos, Catherine R. Norton, Dan Sorescu, Sidra Azim, Sonjoy R. Laskar, Andrew L. Smith, Sandra B. Dunbar, Javed Butler

Research output: Contribution to journalArticle

21 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)569-572
Number of pages4
JournalAmerican Journal of Cardiology
Volume107
Issue number4
DOIs
StatePublished - Feb 15 2011

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Malik, A. S., Giamouzis, G., Georgiopoulou, V. V., Fike, L. V., Kalogeropoulos, A. P., Norton, C. R., Sorescu, D., Azim, S., Laskar, S. R., Smith, A. L., Dunbar, S. B., & Butler, J. (2011). Patient perception versus medical record entry of health-related conditions among patients with heart failure. American Journal of Cardiology, 107(4), 569-572. https://doi.org/10.1016/j.amjcard.2010.10.017