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PubMed2000

Truth or consequences: the validity of self-report data in health services research on addictions.

This paper examines factors that influence the veracity of verbal self-report data in health services research, using a cognitive social-psychological model of the data-gathering process as an organizing framework. It begins by briefly summarizing the consequences that can result from measurement error. Next, a cognitive social-psychological model of the question-answering process is presented. Common assumptions regarding the utility of specific assessment methods are evaluated with particular emphasis on the strengths and weaknesses of alternative data sources. The framework is then applied specifically to understanding the factors that may affect self-report measures in health services research relating to alcohol and other substance use. Overall, self-report procedures can provide useful estimates of consumption in clinical settings when conditions are designed to maximize response accuracy.

Alcohol Drinking↗
PubMed1989

Structure of act-report data: is the five-factor model of personality recaptured?

We examined the correspondence between the structure of act-report data and 5-factor models emerging from trait-rating data. Twenty categories were selected as markers for the 5-factor model and retrospective act reports were constructed for the target categories. One hundred eighteen men and women comprising 59 dating couples completed self-based and observer-based act reports. Several factor analyses tested different assumptions. Retaining total act performance (TAP) produced a blend of the traditional 5 factors. Removing TAP closely reproduced the 5-factor model in both principal-components and procrustes analyses. Correlations between the derived act factors and trait ratings from 6 data sources support a reinterpretation of the traditional trait labels. Discussion focuses on the implications of different assumptions on the formulation of a basic model of personality structure.

Adult↗
PubMed2007

Self-reported data from patients with bipolar disorder: frequency of brief depression.

OBJECTIVE: Patients with bipolar disorder often report depressive symptoms that do not meet the DSM-IV criteria for an episode. Using daily self-reported mood ratings, we studied how changing the length requirement to that typical of recurrent brief depression (2-4 days) would impact the number of depressed episodes. METHOD: 203 patients (135 bipolar I and 68 bipolar II by DSM-IV criteria) recorded mood daily using ChronoRecord software on a home computer (30,348 total days; mean 150 days). Episodes of depression and days of depression outside of episodes were determined. Symptom intensity (mild versus moderate or severe) was investigated within and outside of depressive episodes. RESULTS: Decreasing the minimum duration criterion for an episode of depression to 2 days increased the number of patients with a depressed episode two and a half times (52 to 131), and quadrupled both the number of depressed episodes per patient (0.62 to 2.88) and the number of depressed episodes for all patients (125 to 584). With a 2-day episode length, 34% of days of depression remained outside an episode. The ratio of days with severe symptoms within episodes remained consistent (about 25%) in spite of decreasing the episode length to 2 days. Considering only days with severe symptoms, about 25% remained outside of episodes even with a 2-day length. None of the results distinguished bipolar I from bipolar II disorder. LIMITATIONS: Self-reported data, computer access required, relatively short study length, no control group. CONCLUSION: Brief depressive episodes and single days of depression outside of episodes occur frequently in both bipolar I and bipolar II disorder. Moderate or severe symptoms occur during brief episodes at a ratio similar to that for episodes that meet the DSM-IV criteria.

Adult↗
PubMed1998

Assessing the feasibility of using computerized pharmacy refill data to monitor antidepressant treatment on a population basis: a comparison of automated and self-report data.

This article compares self-report and automated data as measures of dose and duration of antidepressant use in order to assess the feasibility of using automated pharmacy data in a disease management context. We used self-report and computerized refill data to identify two treatment failures-premature discontinuation of the medication and sub-optimal dosages-at time points 1 and 4 months after initiation of antidepressant therapy. The sources showed modest agreement regarding identification of current users at 1 month (kappa = .33); agreement was high at 4 months (kappa = .72). Agreement regarding dosage adequacy was also higher later in treatment, with kappas of .52 and .65 at 1 and 4 months, respectively. The two sources showed high agreement on an overall measure of acute phase treatment adequacy (kappa = .80). Data completeness was another outcome, with data on current users and overall treatment adequacy generally available from computerized files, data on dose less so. Automated pharmacy data appear to be a feasible means of monitoring treatment adequacy and quality of care as part of a disease management approach to improving care for populations of patients.

Antidepressive Agents↗
PubMed1985

Self-reported data on spontaneous abortions compared with data obtained by computer linkage with the hospital registry.

In a study of occupational causes of spontaneous abortions, based upon self-reported data and data from the hospital registry, evidence of differential misclassification was noted. Among those exposed a larger proportion of the self-reported spontaneous abortions were identified in the hospital registry, compared with what was found in the control group. This could be due to recall bias of the questionnaire data masking an effect of exposure, or a lower threshold for hospitalization among those exposed vis-à-vis controls, which would exaggerate the effect of exposure, if any. The analysis tended to support the idea of a less accurate recall of spontaneous abortions among controls, especially for abortion that occurred more than 3 years before the questionnaires were sent out. A second questionnaire was sent out to a subset of the participants 3 1/2 years after the first questionnaire. 17% reported fewer spontaneous abortions in this second questionnaire compared with the situation in the first questionnaire, for the period 1973 to 1980.

Abortion, Spontaneous↗
PubMedDate not supplied

Calculating similarities between biological activities in the MDL Drug Data Report database.

There are a number of licensed databases that assign biological activities to druglike compounds. The MDL Drug Data Report (MDDR), compiled from the patent literature, is a popular example. It contains several hundred distinct activities, some of which are therapeutic areas (e.g., Antihypertensive) and some of which are related to specific enzymes or receptors (e.g., ACE inhibitor). There are several data mining applications where it would be useful to calculate a similarity between any two activities. Two distinct activity labels can have a significant similarity for a number of reasons: two activities can be nearly synonymous (e.g., CCK B antagonist vs Gastrin antagonist), one activity may be a subset of another (e.g., Dopamine (D2) agonist vs Dopamine agonist), or an activity can be the mechanism by which another activity works (e.g., ACE inhibitor vs Antihypertensive), etc. In an ideal world, similarities for two activities could be calculated simply by comparing the compounds they have in common, but in hand-curated databases such as the MDDR the assignment of activities to compounds are inevitably inconsistent and incomplete. We propose a number of methods of calculating activity-activity similarities that hopefully compensate for errors in hand-curation. Two of these, TIMI and trend vector, show promise. Soft clustering of the activities using a union of similarity methods shows a reasonable association of therapeutic areas with their mechanisms.

Algorithms↗
PubMed2004

Assessment of individual risk of death using self-report data: an artificial neural network compared with a frailty index.

OBJECTIVES: To evaluate the potential of an artificial neural network (ANN) in predicting survival in elderly Canadians, using self-report data. DESIGN: Cohort study with up to 72 months follow-up. SETTING: Forty self-reported characteristics were obtained from the community sample of the Canadian Study of Health and Aging. An individual frailty index score was calculated as the proportion of deficits experienced. For the ANN, randomly selected participants formed the training sample to derive relationships between the variables and survival and the validation sample to control overfitting. An ANN output was generated for each subject. A separate testing sample was used to evaluate the accuracy of prediction. PARTICIPANTS: A total of 8,547 Canadians aged 65 to 99, of whom 1,865 died during 72 months of follow-up. MEASUREMENTS: The output of an ANN model was compared with an unweighted frailty index in predicting survival patterns using receiver operating characteristic (ROC) curves. RESULTS: The area under the ROC curve was 86% for the ANN and 62% for the frailty index. At the optimal ROC value, the accuracy of the frailty index was 70.0%. The ANN accuracy rate over 10 simulations in predicting the probability of individual survival mean+/-standard deviation was 79.2+/-0.8%. CONCLUSION: An ANN provided more accurate survival classification than an unweighted frailty index. The data suggest that the concept of biological redundancy might be operationalized from health survey data.

Aged↗
PubMed2002

The evaluation of mental health outcome at a community-based psychodynamic psychotherapy service for young people: a 12-month follow-up based on self-report data.

The present study focuses on the evaluation of mental health outcome of 151 young people who received psychodynamic psychotherapy at the Brandon Centre, a community-based psychodynamic psychotherapy centre; for young people. This paper reports the results from a 1-year follow-up based on self-report data. Participants aged 12-18 years completed either the Youth Self Report form or, if they were aged over 18, the Young Adult Self Report form at intake, 3 months, 6 months, and 1 year. The domains evaluated included young people's externalizing problems, internalizing problems, and total problems. Outcome was measured in three different ways: the change in mean scores; the change in numbers from the clinical to the non-clinical range; and categorizing cases according to the presence of statistically reliable change in the level of adaptation. These approaches showed improvement among participants in all three domains. Although there was a high general tendency to improve, the rate of improvement dropped significantly over time. Several tentative predictors of improvement were identified. The paper discusses how the results from systematic monitoring of effectiveness at the Brandon Centre have formed an empirical basis that has led to changes in service delivery with the aim of optimizing provision for troubled young people.

Adolescent↗
PubMed2006

Breast imaging and reporting data system (BIRADS): magnetic resonance imaging.

This article reviews the technical aspects and interpretation criteria in breast MR imaging based on the first edition of breast imaging and reporting data system (BIRADS) published by the American College of Radiology (ACR) in 2003. In a second article, practical cases will be proposed for training the readers. The major aims of using this lexicon are: first to use a logical and standardized description of MR lesions, secondly to obtain a structured MR report with a clear final impression (BIRADS assessment categories), and thirdly to help comparison between different clinical studies based on similar breast MRI terminology.

Breast Neoplasms↗
PubMed1996

Evaluating clinical case report data for SAR modeling of allergic contact dermatitis.

Clinical case reports can be important sources of information for alerting health professionals to the existence of possible health hazards. Isolated case reports, however, are weak evidence of causal relationships between exposure and disease because they do not provide an indication of the frequency of a particular exposure leading to a disease event. A database of chemicals causing allergic contact dermatitis (ACD) was compiled to discern structure-activity relationships. Clinical reports represented a considerable fraction of the data. Multiple Computer Automated Structure Evaluation (MultiCASE) was used to create a structure-activity model to be used in predicting the ACD activity of untested chemicals. We examined how the predictive ability of the model was influenced by including the case report data in the model. In addition, the model was used to predict the activity of chemicals identified from clinical case reports. The following results were obtained: When chemicals which were identified as dermal sensitizers by only one or two case reports were included in the model, the specificity of the model was reduced. Less than one half of these chemicals were predicted to be active by the most highly evidenced model. These chemicals possessed substructures not previously encountered by any of the models. We conclude that chemicals classified as sensitizers based on isolated clinical case reports be excluded from our model of ACD. The approach described here for evaluating activity of chemicals based on sparse evidence should be considered for use with other endpoints of toxicity when data are correspondingly limited.

Allergens↗
PubMed1999

Comparison of self-report data and medical records data: results from a case-control study on prostate cancer.

BACKGROUND: Self-report and review of medical records are the most common methods for the assessment of past exposures. However, information obtained from self-reports and medical records may not be consistent. This study compared information provided in a self-administered questionnaire with medical records data. METHODS: Self-report and medical records data came from a case-control study on prostate cancer. Cases were 181 patients with primary prostate cancer and controls were 297 men without the disease, enrolled in Group Health Cooperative (GHC) in Seattle. The consistencies between the two data sources were examined. RESULTS: In general, agreement between the two data sources was almost perfect for demographic and anthropometric variables, substantial for the history of inguinal hernia and kidney stones, and moderate for vasectomy, family history of prostate cancer, smoking and alcohol consumption. However, the two data sources generally were poorly concordant for prior genitourinary diseases that have less explicit diagnostic criteria such as benign prostatic hyperplasia and prostatitis. Analyses of discordant data showed that men were more likely to report an exposure or medical condition that could not be verified from medical records. No discernible patterns in the difference of agreement were found according to age, GHC membership length or case-control status. CONCLUSIONS: This study suggests that agreement between self-reported data and medical records data varies depending upon the study variables. While both data sources are subject to some problems, self-report may provide more complete and comparable information, at least for variables unrelated to diagnosis.

Adult↗
PubMed1999

Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Surveillance Report, data summary from January 1996 through December 1997: A report from the National Nosocomial Infections Surveillance (NNIS) System.

The Intensive Care Antimicrobial Resistance Epidemiology project has established laboratory-based surveillance for antimicrobial resistance and antimicrobial use at a subset of hospitals participating in the National Nosocomial Infections Surveillance system. These data illustrate that, for most antimicrobial resistant organisms studied, rates of resistance were highest in the intensive care unit areas and lowest in the outpatient areas. For most of the antimicrobial agents, the rate of use was highest in the intensive care unit areas in parallel to the pattern seen for resistance. These comparative data on antimicrobial use and resistance among similar areas (ie, intensive care unit or other inpatient areas) can be used as a benchmark by participating hospitals to focus their efforts at addressing antimicrobial resistance.

Centers for Disease Control and Prevention, U.S.↗
PubMed2006

Self-reported data from patients with bipolar disorder: impact on minimum episode length for hypomania.

OBJECTIVE: Some investigators have suggested decreasing the minimum hypomania episode length criterion from 4 days, as in the DSM-IV, to 2 days. Using daily self-reported mood ratings, we studied the impact of changing the length requirement on the number of hypomanic episodes in patients with bipolar disorder. METHOD: 203 patients (135 bipolar I and 68 bipolar II by DSM-IV criteria) recorded mood daily using ChronoRecord software (30,348 total days, mean 150 days). Episodes of hypomania and days of hypomania outside of episodes were determined. RESULTS: Decreasing the minimum duration criterion for an episode of hypomania from 4 to 2 days doubled the mean percent of days in a hypomanic episode for each patient (4% to 8%), doubled the number of patients with a hypomanic episode (44 to 96) and increased the number of hypomanic episodes for all patients about three-fold (129 to 404). With a minimum episode length of 4 days, bipolar I patients were more likely to report hypomania outside episodes than bipolar II patients (p=0.010), but with a length of 2 or 3 days there was no significant difference in the distribution of hypomania outside of episodes by diagnosis. With a 2-day length, about one-third (36%) of hypomania remained outside of an episode. LIMITATIONS: Self-reported data, computer access, relatively short length, fewer bipolar II than bipolar I patients. CONCLUSION: As the minimum length for an episode of hypomania decreases, there was a large increase in both the number of episodes and number of patients with episodes. One-day hypomania outside of episodes occurs frequently in both bipolar I and bipolar II disorder.

Adult↗
PubMed2006

Obtaining self-report data from cognitively impaired elders: methodological issues and clinical implications for nursing home pain assessment.

PURPOSE: We developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. DESIGN AND METHODS: Using a modification of the Geriatric Pain Measure (GPM-M2), we interviewed 61 residents from two nursing homes (Mini-Mental State Examination score, M = 15 +/- 7) once a week for 4 consecutive weeks. We collected additional data by means of chart review, cognitive status assessments, and surveys of certified nursing assistants. We used descriptive and correlational analyses to address our primary aims. RESULTS: Eighty-nine percent of residents completed all four scheduled interviews. Cognitive status was not significantly correlated with number of nonresponses and prompts for yes-no questions, but it was significantly correlated with nonresponses and prompts for Likert-scale questions (r = -.48, p <.001 and r = -.59, p <.001, respectively). Completion time for the 17-item pain measure (M = 13 min) was not predicted by cognitive status. Residents' scores on the GPM-M2 were significantly correlated with number of chronic pain-associated diagnoses, r =.37, p <.01, and internal consistency was excellent, alpha = 0.87 - 0.91. Residents' GPM-M2 scores were stable over time, r =.74-.80, p <.0001, for all comparisons. IMPLICATIONS: Using explicit protocols and reporting procedural data allows researchers and clinicians to better understand and apply results of self-report studies with cognitively impaired elders. Results suggest that many nursing home residents can provide consistent and reliable self-report pain data, given appropriate time and assistance.

Aged↗
PubMedDate not supplied

Adventures in environmental data reporting: high tech, low tech, and everything in between or Wisconsin DNR's reporting systems move toward the future.

Electronic data transmittal and data warehouses seem like obvious solutions for streamlining reporting systems and managing large bodies of data; however, regulatory agencies like Wisconsin Department of Natural Resources (DNR) face significant barriers in implementation. In addition to the development costs to the Agency, regulators may be limited by the capabilities of the regulated community and the perceived burden for small businesses and communities. Electronic systems can be implemented incrementally if supported by state regulations and processes for insuring data integrity.

Conservation of Natural Resources↗
PubMed1990

Patterns of conscious failure to provide accurate self-report data in patients with low back pain.

Assessment and treatment responses were compared in 17 subjects with chronic low back pain assessed as showing at least one clear consciously produced inconsistency in statements and/or behaviors during their participation in an interdisciplinary treatment program and 143 subjects assessed as showing no such inconsistency. Numerous statistically significant differences emerged: Inconsistent subjects were more likely to have pending litigation and to be assessed by staff as showing a higher degree of focus on pain and more dramatized complaints, lower levels of medical findings and attention and interest in treatment, and poor compliance with treatment and assessment procedures. In addition, these subjects reported lower levels of physical activity and generally more inconsistent or negative responses to lumbar sympathetic injections with fewer expected changes in physical sensations. Though not definitive, these results suggested a syndrome of characteristics among such subjects which are similar to those proposed as likely characterizing malingerers. The need for a particularly careful validation of self-report data in patients showing many of these characteristics was emphasized.

Adult↗