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Early childhood chronic illness: comparability of maternal reports and medical records
J E Miller1, D Gaboda, D Davis
1Institute for Health, Health Care Policy and Aging Research, Rutgers University, 30 College Ave., New Brunswick, NJ 08901-5070, USA. jemrci@rutgers.edu
Insights
Maternal reports and medical records show poor agreement on child health conditions. Discrepancies were greatest for children from disadvantaged backgrounds, impacting accurate health assessments.
Area of Science:
- Pediatric Health Data Analysis
- Health Information Systems
- Childhood Chronic Conditions
Background:
- Maternal reports and medical records are key sources for child health data.
- Assessing the comparability of these data sources is crucial for accurate health surveillance and clinical care.
- Previous studies have indicated potential discrepancies, but comprehensive quantitative analysis is needed.
Purpose of the Study:
- To quantitatively compare the agreement between maternal reports and medical records for 15 chronic child health conditions.
- To identify specific conditions with significant discordance between the two data sources.
- To examine how demographic factors influence the agreement between maternal and medical data.
Main Methods:
- Utilized data from a nationally representative sample of 6201 preschool children from the 1991 Longitudinal Followup (LF) to the 1988 National Maternal and Infant Health Survey (NMIHS).
- Collected data through maternal questionnaires and medical record reviews from healthcare providers.
- Employed Kappa statistics to assess agreement between maternal reports and medical records for various chronic health conditions.
Main Results:
- Poor agreement (Kappa statistics) was found for 12 out of 15 chronic health conditions studied.
- Weighted prevalence estimates varied significantly between maternal reports and medical records.
- Lower agreement rates were observed for children from socioeconomically disadvantaged families (poor, less educated, Hispanic).
Conclusions:
- Significant discordance exists between maternal reports and medical records in identifying child chronic health conditions.
- Discrepancies highlight potential biases and limitations in relying on single data sources for child health assessment.
- Findings underscore the need for triangulating data sources and considering socioeconomic factors in child health research and practice.
Objectives:
The research reported here seeks to quantitatively assess the comparability of two widely used sources of information on child health: maternal reports and medical records. The analysis provides a comparison of how well maternal reports and medical provider data agree on 15 types of chronic health conditions, ranging from specific illnesses such as asthma or sickle cell anemia to broader categories such as chronic heart or orthopedic conditions, to impairments such as vision, hearing, or speech problems.
Methods:
This study uses data on a nationally representative sample of 6201 preschool aged children whose mothers participated in the 1991 Longitudinal Followup (LF) to the 1988 National Maternal and Infant Health Survey (NMIHS) and whose identified health care providers supplied medical visit data for the children. The LF and NMIHS were conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), in collaboration with a number of other agencies of the Federal Government. In the 1991 LF survey, the mothers' questionnaire included questions on chronic and acute health conditions, accidents requiring medical attention, and hospital admissions for their children that had been included in the 1988 NMIHS. The mothers were also asked to grant NCHS permission to request medical records from the children's medical providers.
Results:
Kappa statistics reveal poor agreement for 12 of 15 conditions studied. Weighted prevalence estimates vary widely across sources. For some conditions, despite apparently similar prevalence estimates from the two sources, mothers' reports and medical records identified very different groups of children as "cases." Concurrence rates were lower for children from poor, less educated, and Hispanic families. Reasons for and implications of these findings are also discussed.
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