Validation of claims diagnoses and self-reported conditions compared with medical records for selected chronic diseases

J Ambul Care Manage. 1998 Jan;21(1):24-34. doi: 10.1097/00004479-199801000-00004.


This article assesses the validity of ambulatory administrative and encounter data and patient self-reported information compared with information contained in the ambulatory medical record for 17 chronic diseases. Using a sample of 213 adults (18 to 64 years old) and seniors (65 years and older) enrolled in a health maintenance organization and receiving care at multispecialty group practice in Minneapolis, Minnesota, sensitivity and specificity for claims and self-report were calculated for each chronic condition using the medical record as the criterion standard. The analysis was performed first by blinded review and then repeated with an unblinded review.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care Information Systems / standards
  • Chronic Disease / epidemiology*
  • Chronic Disease / therapy
  • Data Collection / methods*
  • Data Collection / standards
  • Female
  • Humans
  • Insurance Claim Reporting / standards
  • Male
  • Medical Audit
  • Medical Records / standards*
  • Middle Aged
  • Minnesota / epidemiology
  • Quality Assurance, Health Care / methods
  • Self Disclosure*