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Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records.

Publication ,  Journal Article
Valikodath, NG; Newman-Casey, PA; Lee, PP; Musch, DC; Niziol, LM; Woodward, MA
Published in: JAMA Ophthalmol
March 1, 2017

IMPORTANCE: Accurate documentation of patient symptoms in the electronic medical record (EMR) is important for high-quality patient care. OBJECTIVE: To explore inconsistencies between patient self-report on an Eye Symptom Questionnaire (ESQ) and documentation in the EMR. DESIGN, SETTING, AND PARTICIPANTS: This investigation was an observational study in comprehensive ophthalmology and cornea clinics at an academic institution among a convenience sample of 192 consecutive eligible patients, of whom 30 declined participation. Patients were recruited at the Kellogg Eye Center from October 1, 2015, to January 31, 2016. Patients were eligible to be included in the study if they were 18 years or older. MAIN OUTCOMES AND MEASURES: Concordance of symptoms reported on an ESQ with data recorded in the EMR. Agreement of symptom report was analyzed using κ statistics and McNemar tests. Disagreement was defined as a negative symptom report or no mention of a symptom in the EMR for patients who reported moderate to severe symptoms on the ESQ. Logistic regression was used to investigate if patient factors, physician characteristics, or diagnoses were associated with the probability of disagreement for symptoms of blurry vision, pain or discomfort, and redness. RESULTS: A total of 162 patients (324 eyes) were included. The mean (SD) age of participants was 56.6 (19.4) years, 62.3% (101 of 162) were female, and 84.9% (135 of 159) were white. At the participant level, 33.8% (54 of 160) had discordant reporting of blurry vision between the ESQ and EMR. Likewise, documentation was discordant for reporting glare (48.1% [78 of 162]), pain or discomfort (26.5% [43 of 162]), and redness (24.7% [40 of 162]), with poor to fair agreement (κ range, -0.02 to 0.42). Discordance of symptom reporting was more frequently characterized by positive reporting on the ESQ and lack of documentation in the EMR (Holm-adjusted McNemar P < .03 for 7 of 8 symptoms except for blurry vision [P = .59]). Return visits at which the patient reported blurry vision on the ESQ had increased odds of not reporting the symptom in the EMR compared with new visits (odds ratio, 5.25; 95% CI, 1.69-16.30; Holm-adjusted P = .045). CONCLUSIONS AND RELEVANCE: Symptom reporting was inconsistent between patient self-report on an ESQ and documentation in the EMR, with symptoms more frequently recorded on a questionnaire. These results suggest that documentation of symptoms based on EMR data may not provide a comprehensive resource for clinical practice or "big data" research.

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Published In

JAMA Ophthalmol

DOI

EISSN

2168-6173

Publication Date

March 1, 2017

Volume

135

Issue

3

Start / End Page

225 / 231

Location

United States

Related Subject Headings

  • Young Adult
  • Vision, Ocular
  • Surveys and Questionnaires
  • Self Report
  • Self Disclosure
  • ROC Curve
  • Quality Assurance, Health Care
  • Patient Reported Outcome Measures
  • Ophthalmology & Optometry
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Valikodath, N. G., Newman-Casey, P. A., Lee, P. P., Musch, D. C., Niziol, L. M., & Woodward, M. A. (2017). Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records. JAMA Ophthalmol, 135(3), 225–231. https://doi.org/10.1001/jamaophthalmol.2016.5551
Valikodath, Nita G., Paula Anne Newman-Casey, Paul P. Lee, David C. Musch, Leslie M. Niziol, and Maria A. Woodward. “Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records.JAMA Ophthalmol 135, no. 3 (March 1, 2017): 225–31. https://doi.org/10.1001/jamaophthalmol.2016.5551.
Valikodath NG, Newman-Casey PA, Lee PP, Musch DC, Niziol LM, Woodward MA. Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records. JAMA Ophthalmol. 2017 Mar 1;135(3):225–31.
Valikodath, Nita G., et al. “Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records.JAMA Ophthalmol, vol. 135, no. 3, Mar. 2017, pp. 225–31. Pubmed, doi:10.1001/jamaophthalmol.2016.5551.
Valikodath NG, Newman-Casey PA, Lee PP, Musch DC, Niziol LM, Woodward MA. Agreement of Ocular Symptom Reporting Between Patient-Reported Outcomes and Medical Records. JAMA Ophthalmol. 2017 Mar 1;135(3):225–231.

Published In

JAMA Ophthalmol

DOI

EISSN

2168-6173

Publication Date

March 1, 2017

Volume

135

Issue

3

Start / End Page

225 / 231

Location

United States

Related Subject Headings

  • Young Adult
  • Vision, Ocular
  • Surveys and Questionnaires
  • Self Report
  • Self Disclosure
  • ROC Curve
  • Quality Assurance, Health Care
  • Patient Reported Outcome Measures
  • Ophthalmology & Optometry
  • Middle Aged