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Informant discrepancy between caretakers in history reporting in veterinary dermatology
Joseph Cordonier1, Tyler Udenberg1, Vincent Defalque1
1North West Veterinary Dermatology Services, 1380 Kootenay Street, Vancouver, British Columbia V5K 4R1 (Cordonier, Udenberg, Korbelik); North West Veterinary Dermatology Services, 108-1497 Admirals Road, Victoria, British Columbia V9A 2P8 (Defalque); The Mountain-Whisper-Light Statistics and Data Sciences, 1827 23rd Avenue East, Seattle, Washington 98112-2913, USA (Miljacic, Polissar).
Background:
Collection of medical history is essential for making informed clinical decisions in veterinary medicine. In veterinary dermatology, historical patterns may alter a clinician's diagnostic and therapeutic recommendations. Veterinary patient reporting has similarities to reporting in human pediatric medicine, in which clinician history is collected from caretakers instead of patients themselves. Informant discrepancy between medical histories taken from co-parents has been observed in human pediatric medicine but has not been assessed in veterinary medicine.
Objective:
The objective of this questionnaire-based, prospective, descriptive study was to investigate informant agreement among caretakers of veterinary dermatology patients.
Participants And Procedure:
A caretaker history questionnaire was designed to assess the primary concern of the caretaker, seasonality and duration of clinical signs, pruritus score, areas of the body affected, dietary history, and medication history. At initial dermatology consultations, caretakers completed the questionnaire in separate rooms, as anonymized pairs. Agreement proportion was analyzed by calculating the proportion of pairs, among all pairs, in which both caretakers agreed.
Results:
Fifty-three paired responses (106 caretakers) volunteered for the study. Agreement was highest for histories of gastrointestinal signs (94.1%), skin disease exacerbation by diet (84.3%), and duration of disease (80.4%). Caretakers reported pruritus visual analogue scores within 2 score units of one another for 61.5% of patients. "Individual affected body part" agreement and "individual protein consumed" agreement proportions were 53.5 and 55.7%, respectively. The lowest agreement was seen for seasonality of disease (38.5%) and individual medication use (38.7%).
Conclusion And Clinical Relevance:
Our findings supported the concept that informant discrepancy exists between caretaker histories reported in veterinary dermatology, suggesting that all caretakers' histories should be taken into consideration.
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