A study led by a University of North Carolina Lineberger Comprehensive Cancer Center researcher found that a group of prostate cancer patients reliably reported their own medical histories when their responses were compared to their medical records. The findings suggest that patient-generated reports, which researchers argue are less costly than medical record audits, are a reasonable approach for researchers who are conducting observational comparative effectiveness studies.
"For the vast majority of conditions we looked at, patients and their medical records agreed," said the study's senior author Ronald Chen, MD, a UNC Lineberger member and an associate professor in the UNC School of Medicine Department of Radiation Oncology. "Patients really know their own medical conditions, and we can capture this in a reliable way without having to go through the painstaking process of collecting medical records and abstracting information from them. From a research perspective, simply asking patients about their conditions is a really cost efficient way of collecting this information."
For the study, researchers surveyed 881 prostate cancer patients in North Carolina who had participated in the N.C. Prostate Cancer Comparative Effectiveness & Survivorship Study. Researchers asked them to report whether they have a history of 20 different conditions such as heart attack, kidney disease, asthma or arthritis. Then they compared their answers to what was reported in their medical records. More than 90 percent of patients agreed with their medical records for 16 out of 20 conditions. The findings were published Thursday in JAMA Oncology.
For most conditions, the patients' educational status or race were not significantly linked with differences between the medical records and patients' own reports.
"For patients who are on clinical study, whether they have a high school education, or if they have a college degree, we were able to find that patients really knew their medical conditions very well, and that information is similar to what's in the medical record," Chen said.
However, the research team did find that older age was linked with lower agreement between patients and their records for five conditions, including history of heart attack and other heart-related conditions. Chen said this is an area where more research is needed.
"In cancer research, we need to figure out how to capture and account for co-morbid conditions because cancer is often a disease of older men and women, and many patients have other medical conditions," Chen said. "We want to be able to capture this information accurately in research."
In particular, the work is important for research that aims to compare the outcomes and side effects linked to treatment treatments for prostate cancer. Patients' comorbid conditions can heavily influence which type of treatment a prostate cancer patient would be recommended to receive, Chen said.
"When we're comparing one treatment versus another to see which one is more effective in the research setting, we need to balance the comparison groups in terms of patients' comorbid conditions," Chen said. "Being able to gather this information directly from patients could really help with this type of research."
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Fan Ye et al. Comparison of Patient Report and Medical Records of Comorbidities, JAMA Oncology (2017). DOI: 10.1001/jamaoncol.2016.6744