Can self-reported data from patients be trusted? Depends on the outcome
As the saying goes, You can’t always believe what you hear. But when it comes to patients self-reporting health care utilization, just how accurate can people be? A study, published July 30 in the Journal of Medical Internet Research, examined patients’ abilities to recall complications in the 90 days after orthopedic procedures through an automated online patient engagement survey.
The researchers—led by Benjamin I. Roser, MD, PhD, with Kaiser Permanente in Santa Clara, California—conducted the multicenter observational study across 10 orthopedic practices in California and Nevada, including 371 individuals who underwent procedures between March 1, 2015, and July 1, 2016. The cohort averaged 56.5 years in age, and 48.8 percent were female.
Roser and colleagues found:
- Patients were found to have accuracy of self-report characterized by a kappa of 0.80 and agreement of 0.99 and a kappa of 1.00 and agreement of 1.00 for 90-day hospital admissions and pulmonary embolism, respectively.
- Accuracy of self-report of 90-day emergency room/urgent care visits and of surgical site infection were characterized by a kappa of 0.45 and agreement of 0.96 and a kappa of 0.53 and agreement of 0.97, respectively.
- Accuracy for other complications such as deep vein thrombosis, hemorrhage, severe constipation and fracture/dislocation was lower, influenced by low event prevalence rates within the sample.
“[T]his investigation suggests the potential that engaging patients in self-report through such survey modalities may offer for the timely and accurate measurement of matters germane to health care organizations engaged in quality improvement efforts post discharge,” wrote the authors.
Improvement can be dependent on an institution’s understanding of the value of self-reported data from patients.
“If quality improvement is a goal, and readmissions and post-encounter complications represent the last mile in the healthcare quality chain, could patients become active participants by providing accurate and timely information about these outcomes back to healthcare organizations?” said Roser et al.