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How Reliable are Patient-Reported Rehospitalizations? Implications for the Design of Future Practical Clinical Studies.

Publication ,  Journal Article
Krishnamoorthy, A; Peterson, ED; Knight, JD; Anstrom, KJ; Effron, MB; Zettler, ME; Davidson-Ray, L; Baker, BA; McCollam, PL; Mark, DB; Wang, TY
Published in: J Am Heart Assoc
January 25, 2016

BACKGROUND: Longitudinal clinical investigations often rely on patient reports to screen for postdischarge adverse outcomes events, yet few studies have examined the accuracy of such patient reports. METHODS AND RESULTS: Patients with acute myocardial infarction (MI) in the TRANSLATE-ACS study were asked during structured interviews at 6 weeks, 6 months, and 12 months postdischarge to report any rehospitalizations. The accuracy of patient-reported rehospitalizations within 1 year of postdischarge was determined using claims-based medical bill validation as the reference standard. The cumulative incidence of rehospitalizations was compared when identified by patient report versus medical bills. Patients were categorized by the accuracy in reporting events (accurate, under-, or over- reporters) and characteristics were compared between groups. Among 10 643 MI patients, 4565 (43%) reported 7734 rehospitalizations. The sensitivity and positive predictive value of patient-reported rehospitalizations were low at 67% and 59%, respectively. A higher cumulative incidence of rehospitalization was observed when identified by patient report versus medical bills (43% vs 37%; P<0.001). Overall, 18% of patients over-reported and 10% under-reported the number of hospitalizations. Compared with accurate reporters, under-reporters were more likely to be older, female, African American, unemployed, or a non-high-school graduate, and had greater prevalence of clinical comorbidities such as diabetes and past cardiovascular disease. CONCLUSIONS: The accuracy of patient-reported rehospitalizations was low with patients both under- and over-reporting events. Longitudinal clinical research studies need additional mechanisms beyond patient report to accurately identify rehospitalization events. CLINICAL TRIAL REGISTRATION: URL: https://clinicaltrials.gov. Unique identifier: NCT01088503.

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

January 25, 2016

Volume

5

Issue

1

Location

England

Related Subject Headings

  • United States
  • Time Factors
  • Self Report
  • Risk Factors
  • Research Design
  • Reproducibility of Results
  • Patient Readmission
  • Patient Outcome Assessment
  • Patient Discharge
  • Myocardial Infarction
 

Citation

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Krishnamoorthy, A., Peterson, E. D., Knight, J. D., Anstrom, K. J., Effron, M. B., Zettler, M. E., … Wang, T. Y. (2016). How Reliable are Patient-Reported Rehospitalizations? Implications for the Design of Future Practical Clinical Studies. J Am Heart Assoc, 5(1). https://doi.org/10.1161/JAHA.115.002695
Krishnamoorthy, Arun, Eric D. Peterson, J David Knight, Kevin J. Anstrom, Mark B. Effron, Marjorie E. Zettler, Linda Davidson-Ray, et al. “How Reliable are Patient-Reported Rehospitalizations? Implications for the Design of Future Practical Clinical Studies.J Am Heart Assoc 5, no. 1 (January 25, 2016). https://doi.org/10.1161/JAHA.115.002695.
Krishnamoorthy A, Peterson ED, Knight JD, Anstrom KJ, Effron MB, Zettler ME, et al. How Reliable are Patient-Reported Rehospitalizations? Implications for the Design of Future Practical Clinical Studies. J Am Heart Assoc. 2016 Jan 25;5(1).
Krishnamoorthy, Arun, et al. “How Reliable are Patient-Reported Rehospitalizations? Implications for the Design of Future Practical Clinical Studies.J Am Heart Assoc, vol. 5, no. 1, Jan. 2016. Pubmed, doi:10.1161/JAHA.115.002695.
Krishnamoorthy A, Peterson ED, Knight JD, Anstrom KJ, Effron MB, Zettler ME, Davidson-Ray L, Baker BA, McCollam PL, Mark DB, Wang TY. How Reliable are Patient-Reported Rehospitalizations? Implications for the Design of Future Practical Clinical Studies. J Am Heart Assoc. 2016 Jan 25;5(1).
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

January 25, 2016

Volume

5

Issue

1

Location

England

Related Subject Headings

  • United States
  • Time Factors
  • Self Report
  • Risk Factors
  • Research Design
  • Reproducibility of Results
  • Patient Readmission
  • Patient Outcome Assessment
  • Patient Discharge
  • Myocardial Infarction