Concordance between self-reports and archival records of physician visits: A case–control study comparing individuals with and without alcohol use disorders in the community
Open accessAbstract
Objective The accuracy of self-reported healthcare use among individuals with alcohol use disorders (AUD) has been questioned. The present study attempts to compare the accuracy of self-reported physician visits for individuals who differ with respect to their history of AUDs. Methods Our data source was a 14-year follow-up of individuals interviewed at the St. Louis site of the 1981-1983 Epidemiologic Catchment Area Study (ECA). We used a case-control design (n=237) to compare the accuracy of self-reports among ECA participants with stably diagnosed AUDs (cases; n=75) to two comparison groups: those with problem/very heavy drinking (n=81) and those unaffected by alcohol (n=81). Intraclass correlation coefficients (ICC) described the concordance between self-reports and archival records of physician visits in the prior six months. We used multinomial logistic regression to identify characteristics associated with under-reporting and over-reporting, and zero-truncated Poisson regression to identify characteristics associated with discordance severity. Results Self-reports of cases had substantial concordance with physician records (ICC=0.74, CI=0.61-0.83). As compared to cases, those with problem/very heavy drinking had a significantly higher ICC, and those who were unaffected by alcohol had a significantly lower ICC. However, differences in concordance disappeared when using regression models that adjusted for factors known to affect the accuracy of self-reported healthcare use. Utilization frequency was a strong predictor of inaccurate reporting. Conclusions These findings suggest AUD status may not independently affect the accuracy of self-reports. Counts of physician visits for those with AUD may be considered accurate when utilization frequency is low.
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Outcome-level risk of bias focused on the validity of treatment utilization analyses, including instrument measurement properties and blinding of outcome assessment.
“Outcome-level risk of bias focused on the validity of the treatment utilization analyses, including the measurement properties of the instruments (49,50) and blinding of outcome assessment (51).”
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Self-citation
- Authors
- Glass, J. E., & Bucholz, K. K.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Glass, Joseph E.
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 116
- Issue
- 1-3
- Pages
- 57-63
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC3105172
- OpenAlex
- W1985648751
- Cited by
- 20
- References
- 20
- Citations by year
- 2025: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 4 · 2015: 2 · 2014: 2
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (AA11998, AA 12640, R01AA010333, P60AA011998, R01AA012640, AA 10333)
- National Institute of Mental Health (T32MH019960)
- National Institute on Drug Abuse (DA-14363, R01DA014363, T32DA015035)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- alcoholism, physician visits, self-report accuracy, underreporting, overreporting, archival sources, heavy drinking, health care utilization, Epidemiologic Catchment Area study
- MeSH terms
- Adult, Alcohol Drinking, Alcoholism, Cognition Disorders, Community Health Services, Female, Humans, Male, Medical Records, Middle Aged, Office Visits, Physicians, Psychiatric Status Rating Scales, Residence Characteristics, Time Factors, Case-Control Studies, Disease Progression, Alcohol-Related Disorders, Self Report
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