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PubMed1989

Retrospective versus original information on cigarette smoking. Implications for epidemiologic studies.

This study was conducted to evaluate the agreement between retrospective information on cigarette smoking and original information obtained six years previously. A questionnaire on smoking habits was answered by 94% of a random sample of the adult Swedish population in 1963 (original information). Of the 10,356 subjects aged 40-59 years who reported that they had ever smoked regularly, 9,394 answered a second questionnaire in 1969. Information was obtained on present smoking habits as well as on smoking habits in 1963 (retrospective information). Cigarette consumption was divided into four categories: 0, 1-7, 8-15, and 16+ cigarettes per day. In relation to the original information on smoking, retrospective information showed a strong tendency to overestimate previous cigarette consumption among subjects who had increased their cigarette smoking (69%), and to underestimate previous cigarette consumption among subjects who had decreased their cigarette smoking (49%). Subjects with unchanged cigarette consumption showed a high level of agreement between original and retrospective information (89%). Age, sex, income, and occupational status also had some impact on the agreement between retrospective and original information on cigarette consumption. Consequences for epidemiologic studies based on retrospective smoking information are discussed. The use of retrospective information may introduce considerable differential misclassification when cases and noncases differ with regard to changes in smoking habits.

Adult↗
PubMed2001

Blinded review of retrospectively visible unreported breast cancers: an eye-position analysis.

PURPOSE: To determine whether unreported retrospectively identified cancers on mammograms receive prolonged visual attention and can be reliably detected in a blinded review. MATERIALS AND METHODS: Four experienced mammographers performed a blinded review of a test set of 20 retrospective cases where the cancer was not detected until the next mammographic evaluation, 10 prospective cases where the cancer was initially detected, and 10 cancer-free cases. Two views were digitized and displayed on a workstation. The experiment consisted of an initial impression, during which eye position was monitored, and a final impression, during which viewers zoomed on regions of interest and localized suspicious lesions. Eye-position data were analyzed to determine whether retrospectively visible cancers attracted attention to the same degree as prospectively visible cancers. The initial impression used 1,000 msec as the eye-fixation dwell criterion for detecting a lesion. RESULTS: Initially, 70% of retrospective cancers and 50% of prospective cancers did not attract prolonged visual attention. In prospective cases, detailed examination significantly improved the mean receiver operating characteristic area, from.73 to.88 (P <.01), but in retrospective cases, the mean receiver operating characteristic area barely increased, from.60 to.68, due to a high true-positive-to-false-positive ratio. CONCLUSION: At blinded review, detection of retrospectively visible cancers was significantly inferior to that of prospective cancers. It cannot be assumed that retrospectively identified cancers are intrinsically detectable, because they do not draw prolonged visual attention during visual search for breast cancers.

Breast Neoplasms↗
PubMed1999

Intercomparison of retrospective radon detectors.

We performed both a laboratory and a field intercomparison of two novel glass-based retrospective radon detectors previously used in major radon case-control studies performed in Missouri and Iowa. The new detectors estimate retrospective residential radon exposure from the accumulation of a long-lived radon decay product, (210)Pb, in glass. The detectors use track registration material in direct contact with glass surfaces to measure the alpha-emission of a (210)Pb-decay product, (210)Po. The detector's track density generation rate (tracks per square centimeter per hour) is proportional to the surface alpha-activity. In the absence of other strong sources of alpha-emission in the glass, the implanted surface alpha-activity should be proportional to the accumulated (210)Po, and hence to the cumulative radon gas exposure. The goals of the intercomparison were to a) perform collocated measurements using two different glass-based retrospective radon detectors in a controlled laboratory environment to compare their relative response to implanted polonium in the absence of environmental variation, b) perform collocated measurements using two different retrospective radon progeny detectors in a variety of residential settings to compare their detection of glass-implanted polonium activities, and c) examine the correlation between track density rates and contemporary radon gas concentrations. The laboratory results suggested that the materials and methods used by the studies produced similar track densities in detectors exposed to the same implanted (210)Po activity. The field phase of the intercomparison found excellent agreement between the track density rates for the two types of retrospective detectors. The correlation between the track density rates and direct contemporary radon concentration measurements was relatively high, considering that no adjustments were performed to account for either the residential depositional environment or glass surface type. Preliminary comparisons of the models used to translate track rate densities to average long-term radon concentrations differ between the two studies. Further calibration of the retrospective detectors' models for interpretation of track rate density may allow the pooling of studies that use glass-based retrospective radon detectors to determine historic residential radon exposures.

Carcinogens, Environmental↗
PubMed2003

Retrospective drug utilization review, prescribing errors, and clinical outcomes.

CONTEXT: Retrospective drug utilization review is required of all state Medicaid programs and is performed by most private-sector prescription programs. However, it has not been shown to improve clinical outcomes or reduce the rate of potential prescribing errors, known as "exceptions." OBJECTIVE: To look for an effect of retrospective drug utilization review on the rate of exceptions and of clinical outcomes in patients with an exception. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal ecologic study of the rate of exceptions, controlling for preintervention trends and calendar time; and a cohort study of all-cause and cause-specific hospitalizations in patients with an exception, controlling for potential individual-level confounders in 6 Medicaid programs using the same software in the mid-1990s. MAIN OUTCOME MEASURES: The rate of exceptions was examined as a function of retrospective drug utilization review implementation. In addition, before-after comparisons were made of the incidence of all-cause and cause-specific hospitalization in patients with exceptions. RESULTS: We found no reduction in the rate of exceptions coincident with retrospective drug utilization review implementation (rate increase, 0.064 exceptions per 1000 prescriptions per month; 95% confidence interval [CI], -0.006 to 0.133). We also found no effect of retrospective drug utilization review on the incidence of all-cause hospitalization (odds ratio, 0.99; 95% CI, 0.98-1.00) or cause-specific hospitalization. These results persisted in multiple subgroup analyses. Study states intervened using physician alerts in between 1% and 25% of exceptions. CONCLUSIONS: We were unable to identify an effect of retrospective drug utilization review on the rate of exceptions or on clinical outcomes. Given the lack of evidence for effectiveness, and suggestions from previous research of possible harm, policymakers should consider withdrawing the legislative mandate for retrospective drug utilization review.

Drug Utilization Review↗
PubMed2005

Neural correlates of prospective and retrospective memory.

This study examines the event-related brain potential (ERP) correlates of retrieval processes in prospective and retrospective memory (i.e., recognition and cued-recall). In contrast to previous research that has compared performance on tasks measuring prospective and retrospective memory, the stimulus materials and encoding and response demands of the prospective and retrospective components of the tasks were reasonably well matched for the two forms of memory. This resulted in the primary difference between the assessments of prospective and retrospective memory being the requirement for self-initiated retrieval in prospective memory. Analyses of mean amplitude measures revealed modulations of the ERPs typically associated with prospective memory (i.e., N300 and prospective positivity) and retrospective memory (i.e., FN400, parietal positivity and frontal slow waves). Partial least squares analyses revealed one latent variable related to the retrieval of a previously studied item that contrasted retrospective hits and prospective hits from ongoing activity trials and prospective lures; and one latent variable uniquely associated with prospective hits. These findings indicate that similar neural processes support retrieval in prospective and retrospective memory and that the realization of intentions is additionally dependent on processes that are uniquely related to prospective memory.

Adolescent↗
PubMed1988

The psychophysics of retrospective and prospective timing.

In two experiments, different groups of subjects heard four musical selections and then estimated the duration of each selection. Some groups made retrospective time estimates while others made prospective estimates. In both experiments, analyses of the psychophysical relation between perceived and actual duration showed that the slopes of straight-line fits were flatter and accounted for a smaller proportion of the variance under retrospective as compared with prospective conditions. In addition, in experiment 1, retrospective subjects were less accurate in rank ordering the selections from longest to shortest. There was also a serial-order effect, with selections estimated longer when they occurred early in the sequence. In experiment 2 the slopes decreased as the selections in a series became longer. Both retrospective and prospective estimates also exhibited a context effect, in that estimates of a given selection were influenced by the relative durations of the other three selections in the series. The results on inaccurate retrospective judgments raise questions about prior research on stimulus factors and retrospective timing. However, similarities under retrospective and prospective conditions suggest that timing under these conditions, although different in some respects, reflects a similar process.

Adult↗
PubMed2003

The Prospective and Retrospective Memory Questionnaire (PRMQ): Normative data and latent structure in a large non-clinical sample.

The Prospective and Retrospective Memory Questionnaire (PRMQ; Smith, Della Sala, Logie, & Maylor, 2000) was developed to provide a self-report measure of prospective and retrospective memory slips in everyday life. It consists of sixteen items, eight asking about prospective memory failures, and eight concerning retrospective failures. The PRMQ was administered to a sample of the general adult population (N = 551) ranging in age between 17 and 94. Ten competing models of the latent structure of the PRMQ were derived from theoretical and empirical sources and were tested using confirmatory factor analysis. The model with the best fit had a tripartite structure and consisted of a general memory factor (all items loaded on this factor) plus orthogonal specific factors of prospective and retrospective memory. The reliabilities (internal consistency) of the Total scale and the Prospective and Retrospective scales were acceptable: Cronbach's alpha was 0.89, 0.84, and 0.80, respectively. Age and gender did not influence PRMQ scores, thereby simplifying the presentation and interpretation of normative data. To ease interpretation of scores on the PRMQ, tables are presented for conversion of raw scores on the Total scale and Prospective and Retrospective scales to T scores (confidence limits on scores are also provided). In addition, tables are provided to allow users to assess the reliability and abnormality of differences between an individual's scores on the Prospective and Retrospective scales.

Adolescent↗
PubMed1988

Treatment of proteinuric idiopathic glomerulonephritides in adults: a retrospective survey.

PURPOSE: A review of the worldwide medical literature was undertaken to determine whether treatment with currently available drugs has been beneficial in patients with glomerulonephritides. MATERIALS AND METHODS: Thirty-five articles, involving 1,653 adult patients with chronic primary glomerulonephritis with proteinuria and/or nephrotic syndrome, were analyzed. The criteria for inclusion of data were strict, and only complete and well-studied cases were included in the analysis. The papers were grouped into prospective controlled trials, retrospective comparisons of treated and untreated patients, and retrospective studies without an untreated group. RESULTS AND CONCLUSIONS: Analysis of the data shows that patients with minimal change disease clearly benefited from the administration of corticosteroids and/or cytotoxic drugs, since 89 percent and 79 percent of patients had a complete remission in controlled trials and in retrospective studies, respectively. A low incidence of complete and partial remissions was found in the group of patients with focal segmental glomerulosclerosis, proteinuria disappeared in 19 percent, and only 36 percent of these patients had stable renal function after a mean follow-up period of 6.3 years. The incidence of uremia and the number of patients requiring dialysis were very high. In patients with membraneous glomerulonephritis, conflicting results were obtained in controlled trials, retrospective comparisons, and retrospective studies, since a high percentage of complete and partial remissions was present in treated patients from both controlled and retrospective comparisons, whereas the percentage of complete and partial remission in untreated patients increased as the length of the follow-up period increased. Long-term studies carried out on untreated patients confirmed the high percentage of remissions. These data suggest that it is necessary to await future long-term results from controlled trials in order to determine whether or not corticosteroids alone or associated with cytotoxic drugs have a beneficial effect. Finally, the data from patients with mesangiocapillary glomerulonephritis show that therapy appears to have no beneficial effect on renal function. Nephrologists need new drugs that interfere more decisively with the immune process in the pathogenesis of primary glomerulonephritis.

Azathioprine↗
PubMed1986

Missing hospital records: a confounding variable in retrospective studies.

In retrospective chart reviews there are often a certain number of missing hospital records. To elucidate this variable we compared the outcomes of very low birth weight breech infants with respect to the method of collecting data. A prospective sampling, during the hospital stay, of data was performed in 1979 to 1980 and in 1983 to 1984, and the frequencies of very low birth weight were 1.89 and 1.90, respectively, per 1000 live births. For 1981 to 1982 a retrospective record search was performed with the use of the ordinary medical record search system at this institution. For this period 39 of 52 (75%) hospital records were recovered, giving an apparent frequency of 1.32/1000 live births, which differed significantly from either period studied prospectively. An analysis of demographic data of the three groups revealed that the mean gestational age and the mean birth weights were higher in the period studied retrospectively compared with both periods studied prospectively and that the neonatal mortality rates were higher in the periods studied prospectively (74.1% and 57.1%, respectively) than in the period studied retrospectively (28.2%). It is concluded that the more complicated a clinical case is, the more likely the record will not be found for retrospective chart review. This problem should be kept in mind, and it ought to be a requirement that the number of missing charts be stated in retrospective observational studies.

Adult↗
PubMed1996

How reliable are relatives' retrospective reports of terminal illness? Patients and relatives' accounts compared.

To assess the accuracy of relatives' recollections of patients' terminal illness 71 out of 77 caring relatives were re-interviewed about 4 months after they and the patients had given regular interviews throughout care. Current and retrospective ratings of problems and feelings have been compared for agreement, using the kappa index. Several volunteered symptoms showed poor agreement, notably pain, anorexia and depression (kappa = 0.03-0.21), but vomiting, dyspnoea and immobility ratings agreed moderately well (kappa = 0.43-0.68). Current ratings from patients' and relatives' were always in better agreement with each other than with the relatives retrospective ratings. Bias sometimes altered apparent prevalence; pain was described as more severe in retrospect, but weakness, malaise, depression and relatives' stress were under-rated later. Ratings of "discomfort only" became less common for all symptoms retrospectively. The regular current assessments of patients' and relatives' emotional state also agreed only slightly with relatives' follow-up accounts of depression but somewhat better for anxiety. Patients stated knowledge of diagnosis, awareness and acceptance of dying matched the relatives' retrospective assessments moderately well (kappa = 0.70, 0.50 and 0.41). This study and other available evidence indicate that relatives' retrospective reports of terminal illness, measured against current ratings, are moderately reliable for some items but can vary or be potentially misleading over other aspects, including pain. This could affect evaluations of care.

Affect↗
PubMed2003

Development of a quality assessment scale for retrospective clinical studies in pediatric surgery.

BACKGROUND/PURPOSE: More than 97% of the clinical research in pediatric surgery consists of retrospective data. Although these studies have significant limitations, they fundamentally shape clinical practice within the field. In this report, the authors describe the development and potential applications of a standardized quality assessment scale designed for retrospective studies in pediatric surgery. METHODS: The authors developed a comprehensive quality assessment instrument incorporating 30 items within 3 subscales. These subscales were designed to assess 3 integral components of study design: clinical relevance, reporting methodology, and the strength of conclusions. Global quality ratings (poor, fair, or good) were derived by combining scores from each subscale. To examine inter-rater reliability, 10 retrospective studies from the pediatric surgery literature were assessed with the instrument by 6 independent reviewers. RESULTS: Inter-rater reliability was excellent as assessed by the level of agreement for all items within the instrument (84.6% concordance, n = 1,573 total item-choices) and for individual subscales (range, 73.3% to 85.8%, n = 60 to 1,258). The extent of agreement among reviewers was 82% for classifying reports into qualitative categories by global quality scores (n = 60). The ranking of papers by individual reviewers was highly predictive of overall ranking by mean quality scores (n = 60 rank pairs, r = 0.83; P <.01). CONCLUSIONS: The authors have developed a standardized and reliable quality assessment scale for the analysis of retrospective data in pediatric surgery. Potential applications include: (1) providing the practicing surgeon with a knowledge base to critically evaluate published retrospective data; (2) providing a standardized methodology for the systematic review of existing retrospective data; and (3) developing standardized reporting guidelines for use in peer-reviewed journals.

General Surgery↗
PubMed1997

Comparing results of concurrent and retrospective designs in a hospital utilization review.

Hospital utilization reviews are performed on the basis of lists of explicit criteria, such as the Appropriateness Evaluation Protocol, both concurrently and retrospectively, in an increasing number of settings as part of efforts to improve the performance of hospitals and to reduce health care costs. Retrospective data collection has advantages in terms of expenses and ease of sampling, but relies on the quality of medical records. We report on a comparison between concurrent and retrospective data collection performed simultaneously and independently by two reviewers on the same hospital stays in the regional St-Loup Hospital. Results suggest that retrospective data collection produces higher rates of inappropriate hospital utilization, due to a limited number of criteria that are recorded concurrently, but are not found in the retrospective reading of medical records. These results should encourage a further investigation of the comparability between concurrent and retrospective designs in other settings.

Concurrent Review↗
PubMedDate not supplied

Comparison and evaluation of retrospective intermodality brain image registration techniques.

PURPOSE: The primary objective of this study is to perform a blinded evaluation of a group of retrospective image registration techniques using as a gold standard a prospective, marker-based registration method. To ensure blindedness, all retrospective registrations were performed by participants who had no knowledge of the gold standard results until after their results had been submitted. A secondary goal of the project is to evaluate the importance of correcting geometrical distortion in MR images by comparing the retrospective registration error in the rectified images, i.e., those that have had the distortion correction applied, with that of the same images before rectification. METHOD: Image volumes of three modalities (CT, MR, and PET) were obtained from patients undergoing neurosurgery at Vanderbilt University Medical Center on whom bone-implanted fiducial markers were mounted. These volumes had all traces of the markers removed and were provided via the Internet to project collaborators outside Vanderbilt, who then performed retrospective registrations on the volumes, calculating transformations from CT to MR and/ or from PET to MR. These investigators communicated their transformations again via the Internet to Vanderbilt, where the accuracy of each registration was evaluated. In this evaluation, the accuracy is measured at multiple volumes of interest (VOIs), i.e., areas in the brain that would commonly be areas of neurological interest. A VOI is defined in the MR image and its centroid c is determined. Then, the prospective registration is used to obtain the corresponding point c' in CT or PET. To this point, the retrospective registration is then applied, producing c" in MR. Statistics are gathered on the target registration error (TRE), which is the distance between the original point c and its corresponding point c". RESULTS: This article presents statistics on the TRE calculated for each registration technique in this study and provides a brief description of each technique and an estimate of both preparation and execution time needed to perform the registration. CONCLUSION: Our results indicate that retrospective techniques have the potential to produce satisfactory results much of the time, but that visual inspection is necessary to guard against large errors.

Brain↗
PubMed2004

Bias in retrospective studies of trends in asthma incidence.

There is evidence for an increase in adult asthma prevalence. Several retrospective studies have shown an increase in asthma incidence by year of birth, consistent with an increasing trend in asthma incidence. The validity of this retrospective approach is unknown. Retrospective and prospective asthma incidence by year of birth were compared in the same community, during the same time period, from two independent studies; a cohort study and a cross-sectional study in Western Norway. In the prospective study, subjects without asthma were followed from 1985-1996/1997. In the retrospective study in 1998, subjects reported the age at which the disease started. Analyses of incident asthma in the period 1985-1996 were compared between the studies. The retrospective analysis showed a large increase in asthma incidence by year of birth, with an odds ratio (OR) of 2.9 comparing those born in 1969 with those born in 1927. The prospective study showed the opposite, with an OR of 0.2 comparing those born in 1969 with those born in 1927. There was only a 20% difference in the cumulative incidence of asthma. To conclude, retrospective estimates of trends in asthma incidence are likely to be severely biased by differential recall.

Adult↗
PubMed1999

Validity and reliability of retrospective assessment of disease activity and flare in observational cohorts of lupus patients.

BACKGROUND: The use of validated retrospective tools to assess disease activity in an observational cohort of patients would allow researchers the flexibility to analyze unique exploratory questions. Valid, reliable tools exist for assessing disease activity and flare for Systemic Lupus Erythematosus (SLE) patients. However, these tools have been designed for use in structured settings. Many of these populations under study are subject to strict inclusion, exclusion criteria and disease management protocols. The ability to apply these tools to populations not subject to such control would allow researchers to explore questions about unique populations, new treatment applications or predictors of clinical outcomes. This study sought to establish the reliability and validity of retrospective medical record abstraction of SLE disease activity and flare instruments by two rheumatologists. METHODS: From university rheumatology outpatient clinics, 22 patients were randomly selected to establish intra-rater reliability and 26 patients were selected to establish inter-rater reliability. Two rheumatologists using a Physician Global Assessment (PGA), the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Safety of Estrogens in Lupus Erythematosus-National Assessment (SELENA) flare tool retrospectively abstracted patient charts. Agreement between the tools was evaluated to assess validity. RESULTS: The mean patient age was 39 y; 96% were female, 54% Caucasian, 27% Hispanic, 19% Asian; median PGA was 1.4 (on a 0-3 scale) and median SLEDAI score was 4 (range 0-27). Intra-rater reliability for PGA, SLEDAI and the SELENA flare tool was 0.88, 0.87 and 0.52, respectively. Inter-rater reliability for PGA, SLEDAI, and SELENA flare was 0.79, 0.75, and 0. 50, respectively. To assess validity, the tools were compared against each other to assess agreement. From the parent study sample (n=54 patients), the disease activity measures, PGA and SLEDAI demonstrated adequate agreement (r=0.60). However, the SELENA flare tool demonstrated poor agreement with either PGA-defined flare or SLEDAI-defined flare (weighted kappa, 0.29 and 0.40 respectively). PGA-defined and SLEDAI-defined flare also demonstrated poor agreement (weighted kappa, 0.35). CONCLUSIONS: These data suggest that investigators can reliably reproduce patient disease activity through retrospective chart abstraction using PGA and SLEDAI. Assessing flare is a more difficult concept. The validity of assessing flare at a specific patient-visit is poor. Retrospective assessment of patient flare risk over a specified time period is conceptually more valid and avoids difficulties assessing timing and duration of flare. As there have been no similar published prospective analyses of validity using the SELENA flare tool, it is not clear if this problem was unique to the method of retrospective chart abstraction, the nature of non-protocol study patient visits, the tool itself or a combination of all three aspects.

Adult↗
PubMed2000

A comparison of concurrent and retrospective verbal protocol analysis.

In verbal protocol analysis, verbalization can occur either during decision making (concurrent data) or after (retrospective data). Although both methods have advantages and disadvantages, no empirical research has focused on a direct comparison. This study compared the effectiveness of concurrent and retrospective data for revealing the human decision making process. In general, the concurrent protocol analysis method outperformed the retrospective method. Not only was the number of concurrent protocol segments elicited higher than that of retrospective protocol segments, but concurrent data provided more insights into the decision-making steps occurring between stimulus introduction and the final choice outcome. However, retrospective protocols offer an interesting advantage: More statements about the final choice are provided in retrospective protocols than in concurrent protocols.

Data Collection↗
PubMed1992

A comparison of prospective and retrospective diary methods of assessing alcohol use among university undergraduates.

The objective of this study is to compare data about the quantity of alcohol consumed by university undergraduates using a prospective diary with those data collected using a retrospective diary. Five hundred and ninety-eight subjects were randomly selected and divided into two groups matched for age, sex, year of study and subject group; one group received a prospective and one a retrospective questionnaire-301 students received prospective and 297 retrospective questionnaires. Sixty-eight per cent responded to the prospective and 75 per cent to the retrospective survey. There was no significant difference in the median alcohol consumption detected for men or women in this study (p = 0.13; p = 0.47). However, the prospective diary recorded a greater proportion of heavy drinkers, this difference being significant for men and women (p less than 0.05). The quantitative results of the retrospective diary are similar to those obtained by a similar method in a previous survey. The conclusion is that a prospective diary detects a greater proportion of heavy drinkers than a retrospective diary. The prospective survey may be the most appropriate method for assessing alcohol use in certain situations.

Adult↗
PubMed1995

Comparing prospective and retrospective measures of treatment outcomes.

This study examines the correspondence between retrospective and prospective assessments of treatment outcomes among female patients treated for gynecologic symptoms (n = 800) and male patients having surgery for benign prostatic hyperplasia (n = 434). The overall health and symptom status of patients in both samples was assessed at enrollment and again 3 months after treatment; at the 3-month follow-up, patients also were asked to compare retrospectively their current health and how they were feeling with their condition before treatment. Findings indicate that prospective and retrospective measures of change do not yield the same results. Retrospective assessments consistently produce higher estimates of the benefits of treatment, although that pattern was clearer for overall health status than for measures of symptoms. Patients' posttreatment health and symptom status contributes as much to retrospective assessments of change as does prospectively measured change, although the retrospective assessments of female patients whose gynecologic symptoms were medically managed were more strongly related to prospective change than those of hysterectomy patients or prostate surgery patients. Overall, we conclude that these alternative measurement strategies yield divergent assessments of change, depending on the type of treatment a patient receives and, to some extent, what is being measured.

Aged↗