US EPA

2342683 

Journal Article 

Agreement between obstructive airways disease diagnoses from self-report questionnaires and medical records 

Weakley, J; Webber, MP; Ye, F; Zeig-Owens, R; Cohen, HW; Hall, CB; Kelly, K; Prezant, DJ 

2013 

1 

Preventive Medicine
ISSN: 0091-7435
EISSN: 1096-0260 

57 

1 

38-42 

English 

23597657 

10.1016/j.ypmed.2013.04.001 

WOS:000320429400008 

OBJECTIVE: To evaluate agreement between self-reported obstructive airways disease (OAD) diagnoses of asthma, bronchitis, and chronic obstructive pulmonary disease (COPD)/emphysema obtained from the New York City Fire Department (FDNY) monitoring questionnaires with physician diagnoses from FDNY medical records.

METHOD: We measured sensitivity, specificity, and agreement between self-report and physician OAD diagnoses in FDNY members enrolled in the World Trade Center (WTC) monitoring program who completed a questionnaire between 8/2005-1/2012. Using logistic models, we identified characteristics of those who self-report a physician diagnosis that is also reported by FDNY physicians.

RESULTS: 20.3% of the study population (N=14,615) self-reported OAD, while 15.1% received FDNY physician OAD diagnoses. Self-reported asthma had the highest sensitivity (68.7%) and overall agreement (91.9%) between sources. Non-asthma OAD had the lowest sensitivity (32.1%). Multivariate analyses showed that among those with an OAD diagnosis from FDNY medical records, inhaler use (OR=4.90, 95% CI=3.84-6.26) and respiratory symptoms (OR=1.55 [95% CI=1.25-1.92]-1.77 [95% CI=1.37-2.27]) were associated with self-reported OAD diagnoses.

CONCLUSION: Among participants in the WTC monitoring program, sensitivity for self-reported OAD diagnoses ranges from good to poor and improves by considering inhaler use. These findings highlight the need for improved patient communication and education, especially for bronchitis or COPD/emphysema.