Does self-report data on HIV primary care utilization agree with medical record data for socially marginalized populations in the United States?

Nancy L. Sohler, Sharon M. Coleman, Howard Cabral, Sylvie Naar-King, Carol Tobias, Chinazo O. Cunningham

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

To test whether self-report data agree with medical record data in marginalized, HIV-infected populations, we collected information about HIV primary care visits over a 6-month period from both sources. Patients were drawn from a large study of engagement and retention in care conducted between 2003 and 2005. Self-report data were collected in face-to-face interviews and medical records were extracted using a rigorous, standardized protocol with multiple quality checks. We found poor overall agreement (weighted κ = 0.36, 95% confidence interval = 0.28, 0.43). Factors associated with disagreement included younger age (adjusted odds ratio for 20 versus 40 years = 1.25, 95% confidence interval = 0.98, 1.60), non-Hispanic black race/ethnicity (adjusted odds ratio for non-Hispanic blacks versus non-Hispanic whites = 1.48, 95% confidence interval = 1.03, 2.13), lower education (adjusted odds ratio for high school education, GED, or less versus some college or college graduate = 1.43, 95% confidence interval = 0.96, 2.13), and substance use (adjusted odds ratio for any illicit drug/heavy alcohol use in the past 6 months versus no use = 1.39, 95% confidence interval = 1.02, 1.90). These findings do not support a conclusion that unconfirmed self-report data of HIV primary care visits are a sufficient substitute for rigorously collected medical record data in studies focusing on marginalized populations. Use of other data sources (e.g., administrative data), use of other self-reported outcome measures that have better concordance with medical records/administrative data (e.g., CD4 counts), or incorporation of rigorous measures to increase reliability of self-report data may be needed. Limitations of this study include the lack of a true gold standard with which to compare self-report data.

Original languageEnglish (US)
Pages (from-to)837-843
Number of pages7
JournalAIDS Patient Care and STDs
Volume23
Issue number10
DOIs
StatePublished - Oct 1 2009

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Self Report
Medical Records
Primary Health Care
HIV
Confidence Intervals
Odds Ratio
Population
Education
Information Storage and Retrieval
Street Drugs
CD4 Lymphocyte Count
Alcohols
Outcome Assessment (Health Care)
Interviews

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Does self-report data on HIV primary care utilization agree with medical record data for socially marginalized populations in the United States? / Sohler, Nancy L.; Coleman, Sharon M.; Cabral, Howard; Naar-King, Sylvie; Tobias, Carol; Cunningham, Chinazo O.

In: AIDS Patient Care and STDs, Vol. 23, No. 10, 01.10.2009, p. 837-843.

Research output: Contribution to journalArticle

Sohler, Nancy L. ; Coleman, Sharon M. ; Cabral, Howard ; Naar-King, Sylvie ; Tobias, Carol ; Cunningham, Chinazo O. / Does self-report data on HIV primary care utilization agree with medical record data for socially marginalized populations in the United States?. In: AIDS Patient Care and STDs. 2009 ; Vol. 23, No. 10. pp. 837-843.
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