폐암 환자들의 일대일 설문조사와 의무기록의 흡연 습관 비교 (Comparison of Face-to-Face Interview Questionnaires and Medical Records Data for Smoking Habits in Lung Cancer Patients)

서지정보

· 발행기관 : 대한결핵및호흡기학회
· 수록지 정보 : Tuberculosis and Respiratory Diseases / 62권 / 1호 / 27 ~ 32페이지
· 저자명 : 이의철, 조재화, 곽승민, 이홍렬, 유정선, 김현정

초록

연구배경: 폐암환자를 대상으로 의무기록에서 흡연 습관의 정확성을 평가하고, 이에 영향을 미치는 요인들을 분석하고자 한다.연구방법: 폐암을 진단받고 입원한 225예 환자를 대상으로 흡연 습관에 대한 일대일 면접 설문조사와 의무기록 사이의 일치도를 평가하였다. 의무기록의 흡연정보 누락과 두 자료원의 불일치에 기여하는 요인을 평가하기 위하여 다변량 로지스틱 회귀분석을 시행하였다.결 과: 흡연 습관은 전반적으로 증등도의 일치도(κ=0.60)를 보였으며, 과거 흡연의 일치도(κ=0.49)가 가장 낮았다. 의무기록의 흡연정보 누락률은 18.2%였으며, 세포형에 따라 유의한 차이를 보여, 편평상피세포암에 비하여 선암 환자에서의 누락률이 3배 높았다. 두 자료원 사이의 불일치는 65세 미만에 비해 65세 이상에서 3배 많았다.

영어초록

Background: This study evaluated the accuracy of smoking habit from the data obtained from the medical records of lung cancer patients against the data obtained form face-to-face interview questionnaires
Methods: The smoking habits of 225 lung cancer patients were categorized into never smoked, ex-smoker and current smoker in face-to-face interview questionnaire and medical record taken at the time of admission for a diagnosis. The overall agreement between two sources was evaluated. The factors affecting the disagreement between two sources and the level of data omission of the smoking habits in medical records were analyzed suing multiple logistic regression.
Results: The smoking habit between two sources showed moderate overall agreement(Kappa (κ)=0.60). The lowest agreement was observed in the ex-smokers(κ=0.49). Multivariate analysis revealed an age of 65 or older to be a statistically significant factor associated with the increasing disagreement risk compared with those 64 or younger (OR 3.02; 95% CI 1.58-5.80). The omission rate of smoking habits in the medical records was 18.2%. Adenocarcinoma was shown to be a statistically significant factor of associated with an increasing omission rate compared with squamous cell carcinoma (OR 3.00; 95% CI 1.19-7.59).
Conclusion: The smoking habits obtained from medical record moderately reflect their true behavior. However, the smoking habit data from medical record should be used with caution when being used in a clinical study or cohort study of lung cancer. (Tuberc Respir Dis 2007; 62: 27-32)

참고자료

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