Amy M Kilbourne1, Karen Schumacher1, Susan M Frayne2, Yasmin Cypel3, Michelle M Barbaresso1, Kristina M Nord4, Juliette Perzhinsky5, Zongshan Lai6, Katherine Prenovost1, Avron Spiro7, Theresa C Gleason8, Rachel Kimerling2, Grant D Huang9, Tracey B Serpi10, Kathryn M Magruder11. 1. 1 VA Ann Arbor Healthcare System and Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan. 2. 2 Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System and Stanford University School of Medicine , Menlo Park, California. 3. 3 Post Deployment Health Services (10P4Q), Epidemiology Program, Office of Patient Care Services , Department of Veterans Affairs, Washington, District of Columbia. 4. 4 Office of Research and Development, Veterans Health Administration, U.S. Department of Veterans Affairs, Washington, District of Columbia. 5. 5 Aleda E. Lutz VAMC and Central Michigan University College of Medicine, Saginaw, Michigan. 6. 6 Department of Pathology, Beaumont Health System, Troy, Michigan. 7. 7 Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System and Departments of Epidemiology and Psychiatry, Boston University Schools of Public Health and Medicine , Boston, Massachusetts. 8. 8 Patient-Centered Outcomes Research Institute, Clinical Effectiveness & Decision Science, Washington DC. 9. 9 Cooperative Studies Program Central Office, VHA Office of Research and Development, Washington, DC. 10. 10 VA Cooperative Studies Program, Veterans Health Administration , Perry Point, Maryland. 11. 11 Medical University of South Carolina, Charleston, South Carolina, Charleston, South Carolina.
Abstract
BACKGROUND: Little is known about medical morbidity among women Vietnam-era veterans, or the long-term physical health problems associated with their service. This study assessed agreement comparing data on physical health conditions from self-report and medical records from a population-based cohort of women Vietnam-era Veterans from the Health of Vietnam Era Women's Study (HealthViEWS). MATERIALS AND METHODS: Women Vietnam-era veterans (n = 4219) self-completed a survey and interview on common medical conditions. A subsample (n = 900) were contacted to provide permission to obtain medical records from as many as three of their providers. Medical record reviews were conducted using a standardized checklist. Agreement and kappa (agreement beyond chance) were calculated for physical health condition groups. RESULTS: Of the 900, 449 had medical records returned, and of those, 412 had complete surveys/interviews. The most commonly reported conditions based on self-report or medical record review included hypertension, hyperlipidemia, or arthritis. Kappa scores between self-reported conditions and medical record documentation were 0.75-0.91 for hypertension, diabetes, most cancers, and neurological conditions, but lower (k = 0.29-0.55) for cardiovascular diseases, musculoskeletal, and gastrointestinal conditions. Generally, agreement did not significantly vary by different sociodemographic groups. CONCLUSIONS: There was relatively high agreement for physical health conditions when self-report was compared with medical record review. As more women are increasingly represented in the military and more veterans in general seek care outside the Veterans Health Administration, accurate measurement of physical health conditions among population-based samples is crucial.
BACKGROUND: Little is known about medical morbidity among women Vietnam-era veterans, or the long-term physical health problems associated with their service. This study assessed agreement comparing data on physical health conditions from self-report and medical records from a population-based cohort of women Vietnam-era Veterans from the Health of Vietnam Era Women's Study (HealthViEWS). MATERIALS AND METHODS:Women Vietnam-era veterans (n = 4219) self-completed a survey and interview on common medical conditions. A subsample (n = 900) were contacted to provide permission to obtain medical records from as many as three of their providers. Medical record reviews were conducted using a standardized checklist. Agreement and kappa (agreement beyond chance) were calculated for physical health condition groups. RESULTS: Of the 900, 449 had medical records returned, and of those, 412 had complete surveys/interviews. The most commonly reported conditions based on self-report or medical record review included hypertension, hyperlipidemia, or arthritis. Kappa scores between self-reported conditions and medical record documentation were 0.75-0.91 for hypertension, diabetes, most cancers, and neurological conditions, but lower (k = 0.29-0.55) for cardiovascular diseases, musculoskeletal, and gastrointestinal conditions. Generally, agreement did not significantly vary by different sociodemographic groups. CONCLUSIONS: There was relatively high agreement for physical health conditions when self-report was compared with medical record review. As more women are increasingly represented in the military and more veterans in general seek care outside the Veterans Health Administration, accurate measurement of physical health conditions among population-based samples is crucial.
Entities:
Keywords:
epidemiology; medical records; military health; quality of care; survey research; veterans
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