TY - JOUR
T1 - Agreement of Injury Reporting Between Primary Care Medical Record and Maternal Interview for Children Aged 0-3 Years
T2 - Implications for Research and Clinical Care
AU - Stone, Kimberly E.
AU - Burrell, Lori
AU - Higman, Susan M.
AU - McFarlane, Elizabeth
AU - Fuddy, Loretta
AU - Sia, Calvin
AU - Duggan, Anne K.
N1 - Funding Information:
Dr Stone is supported by HRSA Faculty Development grant M418-351-230. This work was supported in part by Federal Maternal and Child Health Bureau (R40 MC 00029 [formerly MCJ 240637], R40 MC 00123 [formerly MCJ 240838]); Robert Wood Johnson Foundation (18303); Annie E. Casey Foundation (94-4041); David and Lucille Packard Foundation (93-6051, 94-7957, 97-8058, 98-3448); Hawaii State Department of Health (99-29-J); and National Institute of Mental Health (R01MH60733).
PY - 2006/3/1
Y1 - 2006/3/1
N2 - Objective: To assess agreement of injury reporting between primary care medical record and maternal interview. Methods: Cross-sectional study of data from a randomized controlled trial of home visiting. The setting was Hawaii's Healthy Start Program (HSP). Subjects comprised a population-based sample of children in at-risk families with 3 years of primary care medical records and maternal interviews (n = 443). Outcome measures were percentage of children injured unintentionally and mean number of injuries per child in the first 3 years of life by primary care medical record and maternal interview. Results: We identified 490 injuries: 48% by primary care medical record, 22% by maternal interview, and 30% in both sources. More children were reported injured by primary care medical record than maternal interview (51% vs 39%, P< .001). The mean number of injuries per child was 0.87 by primary care medical record and 0.51 by maternal interview (difference 0.36, 95% confidence interval 0.27-0.45, P< .001). Agreement between data sources was fair (κ = 0.47). Conclusions: This study estimates that 25% of childhood injuries may not be reported in the medical record, highlighting the need for reconsideration of the use of medical records as the gold standard for unintentional injury data. Caution should be used when interpreting injury data from one source, especially from families with stressful life situations. Poor communication regarding injuries between social service, primary care and urgent care providers may contribute to decreased quality of primary care and missed opportunities for injury prevention.
AB - Objective: To assess agreement of injury reporting between primary care medical record and maternal interview. Methods: Cross-sectional study of data from a randomized controlled trial of home visiting. The setting was Hawaii's Healthy Start Program (HSP). Subjects comprised a population-based sample of children in at-risk families with 3 years of primary care medical records and maternal interviews (n = 443). Outcome measures were percentage of children injured unintentionally and mean number of injuries per child in the first 3 years of life by primary care medical record and maternal interview. Results: We identified 490 injuries: 48% by primary care medical record, 22% by maternal interview, and 30% in both sources. More children were reported injured by primary care medical record than maternal interview (51% vs 39%, P< .001). The mean number of injuries per child was 0.87 by primary care medical record and 0.51 by maternal interview (difference 0.36, 95% confidence interval 0.27-0.45, P< .001). Agreement between data sources was fair (κ = 0.47). Conclusions: This study estimates that 25% of childhood injuries may not be reported in the medical record, highlighting the need for reconsideration of the use of medical records as the gold standard for unintentional injury data. Caution should be used when interpreting injury data from one source, especially from families with stressful life situations. Poor communication regarding injuries between social service, primary care and urgent care providers may contribute to decreased quality of primary care and missed opportunities for injury prevention.
KW - medical record
KW - parent recall
KW - unintentional childhood injuries
KW - wounds and injuries
UR - http://www.scopus.com/inward/record.url?scp=33645748204&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645748204&partnerID=8YFLogxK
U2 - 10.1016/j.ambp.2005.10.003
DO - 10.1016/j.ambp.2005.10.003
M3 - Article
C2 - 16530145
AN - SCOPUS:33645748204
SN - 1530-1567
VL - 6
SP - 91
EP - 95
JO - Ambulatory Pediatrics
JF - Ambulatory Pediatrics
IS - 2
ER -