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EMRs inconsistent with patient-reported eye symptoms
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Significant numbers of symptoms reported by patients on an eye symptom questionnaire were not included in the electronic medical records, according to a study.
The observational study included 162 patients seen in ophthalmology clinics at Kellogg Eye Center.
The eye symptom questionnaire (ESQ), which listed eight symptoms, asked patients to indicate how severe each had been over the previous week. The responses were then compared with the electronic medical records (EMR) kept by clinical staff.
Because data on eye laterality was missing, results were reported in two categories – participant-level and eye-level.
Discordance on each symptom was defined as the presence of a positive indication in the ESQ coupled with either a negative indication or no documentation in the EMR (+ESQ and –EMR).
Results at the participant level revealed discordance on four of the symptoms, three of which showed a large +ESQ and –EMR gap.
For instance, reporting of glare was discordant in 48.1% (78 of 162 reporting it), with 91% of those discordant participants (71 of 78) showing +ESQ and –EMR. Redness was discordant in 24.7% (40 of 162), and of those, 80% (32 of 40) revealed +ESQ and –EMR.
“If the EMR lacks relevant symptom information, it has implications for patient care, including communication errors and poor representation of the patient’s reported problems,” the study’s authors wrote. “The inconsistencies imply caution for the use of EMR data in research studies.” – by Joe Green
Disclosure : The authors report no relevant financial disclosures.
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Valikodath NG, et al. JAMA Ophthalmol 2017;doi:10.1001/jamaophthalmol.2016.5551.
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