Agreement Between Upper Respiratory Diagnoses From Self-Report Questionnaires and Medical Records in an Occupational Health Setting

BackgroundThe 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. MethodsWe measured positive and negative predictive values (PPV, NPV) of self-reported diagnoses of GERD and rhinosinusitis from the health questionnaires in relation to FDNY physician diagnoses from the medical record. ResultsSelf-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. ConclusionThe PPV of self-reported diagnoses demonstrates only modest 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. Am. J. Ind. Med. 57:1181-1187, 2014. (c) 2014 Wiley Periodicals, Inc.