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Recommendations for Care Related to Follow-Up of Abnormal Cancer Screening Tests

Accuracy of Patient Report

University of Massachusetts, School of Public Health

Jane G. Zapka

Medical University of South Carolina

Karin Valentine Goins

University of Massachusetts, Medical School

Marianne Ulcickas Yood

Henry Ford Heath System, Yale University School of Medicine

Judy Mouchawar

Kaiser Permanente, Colorado

Michele Manos

Kaiser Permanente, Oakland, California

Carol Somkin

Kaiser Permanente, Oakland, California

Stephen Taplin

National Cancer Institute

When using patient self-report of processes of care as part of measuring quality performance, validity and reliability are important considerations. In this study, the congruence of patient report of recommendations of screening follow-up care was compared with record audit data. Survey data were collected from a random sample of patients with abnormal breast (n = 230) or cervical (n = 219) cancer screening tests from four health centers. With patient consent, record audits were conducted to validate self-report. Measures of congruence for recommendations for follow-up were calculated along with sensitivity and specificity for procedure-specific recommendations. Overall congruence was higher in the mammography sample (81%) as compared to the Pap sample (61%). Predictors of overall congruence for the abnormal Pap test sample included health plan, self-reported health status, and test result. There were no significant predictors of congruence for the abnormal mammogram test sample from the potential variables collected. Raw agreement rates support using patient self-report in assessing abnormal test follow-up recommendations.

Key Words: congruence • validity • screening follow-up • provider/patient communication • patient surveys • doctor-patient interaction • delivery of health care • survey research

Evaluation & the Health Professions, Vol. 28, No. 3, 310-327 (2005)
DOI: 10.1177/0163278705278273


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