Agreement between upper respiratory diagnoses from self-report questionnaires and medical records in an occupational health setting.
Weakley J; Webber MP; Ye F; Zeig-Owens R; Cohen HW; Hall CB; Kelly K; Prezant DJ
Am J Ind Med 2014 Oct; 57(10):1181-1187
Background: The Fire Department of the City of New York World Trade Center Health Program (FDNY-WTCHP) monitors and treats WTC-related illnesses through regular physical exams, self-administered health questionnaires and treatment visits, as indicated. Methods: We measured positive and negative predictive values (PPV, NPV) of selfreported diagnoses of GERD and rhinosinusitis from the health questionnaires in relation to FDNY physician diagnoses from the medical record. Results: Self-reported GERD had PPV and NPV of 54.0% and 95.7%, respectively; for rhinosinusitis, the PPV and NPV were 48.2% and 91.9%. These characteristics improved considerably (PPV 78.0% GERD and PPV 76.5% rhinosinusitis) in a subpopulation receiving medications from the FDNY-WTCHP. Conclusion: The PPVof self-reported diagnoses demonstrates onlymodest value in predicting physician diagnoses, although high NPVs suggest benefit in ruling out disease. In subgroups selected for their higher disease prevalence, self-reported diagnoses may be considerably more useful.
Injuries; Work-environment; Work-areas; Workers; Humans; Men; Women; Questionnaires; Respiration; Respirators; Respiratory-protection; Respiratory-protective-equipment; Respiratory-system-disorders; Fire-fighters; Demographic-characteristics; Paramedical-services;
Author Keywords: World Trade Center; firefighters and EMS; rhinosinusitis; GERD; medical records; self-report; positive predictive values; negative predictive values
Mayris P. Webber, Dr PH, Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY 11201
Contract; Cooperative Agreement
Contract-200-2011-39378; Contract-200-2011-39383; M092014
American Journal of Industrial Medicine
New York City Fire Department