Agreement between obstructive airways disease diagnoses from self-report questionnaires and medical records

Prev Med. 2013 Jul;57(1):38-42. doi: 10.1016/j.ypmed.2013.04.001. Epub 2013 Apr 16.


Objective: To evaluate agreement between self-reported obstructive airways disease (OAD) diagnoses of asthma, bronchitis, and chronic obstructive pulmonary disease (COPD)/emphysema obtained from the New York City Fire Department (FDNY) monitoring questionnaires with physician diagnoses from FDNY medical records.

Method: We measured sensitivity, specificity, and agreement between self-report and physician OAD diagnoses in FDNY members enrolled in the World Trade Center (WTC) monitoring program who completed a questionnaire between 8/2005-1/2012. Using logistic models, we identified characteristics of those who self-report a physician diagnosis that is also reported by FDNY physicians.

Results: 20.3% of the study population (N=14,615) self-reported OAD, while 15.1% received FDNY physician OAD diagnoses. Self-reported asthma had the highest sensitivity (68.7%) and overall agreement (91.9%) between sources. Non-asthma OAD had the lowest sensitivity (32.1%). Multivariate analyses showed that among those with an OAD diagnosis from FDNY medical records, inhaler use (OR=4.90, 95% CI=3.84-6.26) and respiratory symptoms (OR=1.55 [95% CI=1.25-1.92]-1.77 [95% CI=1.37-2.27]) were associated with self-reported OAD diagnoses.

Conclusion: Among participants in the WTC monitoring program, sensitivity for self-reported OAD diagnoses ranges from good to poor and improves by considering inhaler use. These findings highlight the need for improved patient communication and education, especially for bronchitis or COPD/emphysema.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Environmental Monitoring
  • Female
  • Firefighters / statistics & numerical data*
  • Humans
  • Lung Diseases, Obstructive / diagnosis*
  • Lung Diseases, Obstructive / drug therapy
  • Lung Diseases, Obstructive / epidemiology
  • Male
  • Medical Records
  • Middle Aged
  • New York City
  • Occupational Exposure / adverse effects
  • Occupational Exposure / statistics & numerical data*
  • Program Evaluation
  • Self Report
  • Sensitivity and Specificity
  • September 11 Terrorist Attacks / statistics & numerical data*
  • Surveys and Questionnaires