Agreement of self-reported comorbid conditions with medical and physician reports varied by disease among end-stage renal disease patients

Objective: To compare self-report of eight diseases with review of medical records and physician reports. Study Design and Setting: In a cohort of 965 incident end-stage renal disease (ESRD) patients (Choices for Healthy Outcomes in Caring for End-stage renal disease study), data on existing medical conditions were obtained from medical record abstraction, physician report (CMS Form 2728), and self-report in a baseline questionnaire. We evaluated agreement with kappa statistics (k) and sensitivity of self-report. Regression models were used to examine characteristics associated with agreement. Results: The results showed excellent or substantial agreement between self-report and the medical record for diabetes (k = 0.93) and coronary artery intervention (k = 0.79), and poor agreement for chronic obstructive pulmonary disease (k = 0.20). Physician-reported prevalence for all diseases was equal or lower than that by self-report. Male patients were more likely to inaccurately report hypertension. Compared to white patients, African American patients were more likely to inaccurately report cardiovascular diseases. Conclusion: In ESRD patients, self-report agreement with the medical record varies with the specific disease. Awareness of diseases of the cardiovascular system appears to be low. African American and male ESRD patients are at risk of low awareness of disease and educational interventions are needed in this high-risk population.