Australian Indigenous cancer patients’ self-report of diagnosis, treatment and comorbidity data: how does it compare to medical chart review.

Abstract

Rationale: The quality of patient-centred care relies upon the reliability of the data used to produce performance measures. The agreement between patient self-report and medical chart review among Aboriginal and Torres Strait Islander cancer patients is unknown.Objective: To examine the concordance between patient self-report and medical chart review in determining cancer type, current and previous cancer treatment, comorbidities and patient characteristics associated with agreement.Method: Aboriginal and Torres Strait Islander cancer patients (≥18 years) who had received cancer treatment in the past 30 days (n=208) were recruited. The prevalence, sensitivity, specificity, total agreement and Kappa coefficients (K) were estimated to determine the agreement (yes + yes; no + no) between self-reported data and medical records.Results: 13.5% of the patients could not accurately identify their cancer type. For treatment variables, raw agreement ranged from 70.5% to 92.4%, although, after correcting for chance, there was a lack of consistency for current radiation and past treatment variables (K= -0.01 to 0.48). Sensitivity and specificity were moderate to high for current surgery and chemotherapy. The greatest crude prevalence difference by data source was observed for comorbidities not specified in the questionnaire. Sensitivity and specificity were high for diabetes. Conclusion: investigators and policy makers may rely upon patient self-report for diabetes, current cancer treatment of surgery and chemotherapy. However, should be cautious when considering patient self-report for past treatment and other comorbid conditions.