Discrepancies in physician–patient agreement in reporting ocular history
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OBJECTIVE: The purpose of this study was to investigate the extent of agreement between physicians and patients in reporting ocular history and to determine whether there are any predictive factors for physician-patient consensus. DESIGN: Retrospective chart review. PARTICIPANTS: Between June and September 2014, adult patients undergoing cataract surgery were recruited for the study. METHODS: Before surgery, patient demographics and self-reported ocular history were extracted from a prospectively collected database. Medical charts were retrospectively examined to retrieve physician-reported ocular history. RESULTS: One hundred and thirty-eight patients participated. Mean cohort logMAR visual acuity was 0.46 ± 0.34 (Snellen equivalent of approximately 20/60) and mean age was 74.1 ± 8.3 years. For glaucoma, Cohen's kappa revealed a moderate-to-good concordance between physicians and patients (κ = 0.604), whereas a poor-to-fair level of agreement existed in reporting maculopathy, such as age-related macular degeneration and macular holes (κ = 0.254). The logistic regression model revealed that preoperative visual acuity (p = 0.223), sex (p = 0.736), age (p = 0.910), and education (p = 0.738) were not significant predictors of physician-patient agreement. CONCLUSIONS: The accuracy of patient-reported ocular history varies by pathology. Self-reported glaucoma history is consistent between patients and physicians; however, patients under-report the diagnosis of maculopathy. Age, sex, and level of education do not appear to influence patient-reported accuracy of ocular comorbidities.
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