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American Journal of Medical Quality
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Comparing Self-Reported Measures of Diabetes Care With Similar Measures From a Chart Audit in a Well-Defined Population

Todd S. Harwell, MPH

Montana Diabetes Project, Montana Department of Public Health and Human Services, Helena, MT, tharwell{at}state.mt.us

Kelly Moore, MD

Diabetes Control Program, Billings Area Office, Indian Health Service, Billings, MT

Mary Madison, RN, MSN, CDE

Diabetes Control Program, Billings Area Office, Indian Health Service, Billings, MT

Debbie Powell-Taylor, RN, BSN

Diabetes Control Program, Billings Area Office, Indian Health Service, Billings, MT

Pat Lundgren, RN, EdD, CDE

Diabetes Control Program, Billings Area Office, Indian Health Service, Billings, MT

Jane G. Smilie, BA

Montana Diabetes Project, Montana Department of Public Health and Human Services, Helena, MT

Kelly J. Acton, MD, MPH

Indian Health Service Diabetes Program, Albuquerque, NM

Steven D. Helgerson, MD, MPH

Montana Diabetes Project, Montana Department of Public Health and Human Services, Helena, MT

Dorothy Gohdes, MD

Montana Diabetes Project, Montana Department of Public Health and Human Services, Helena, MT

The objective of this study was to compare self-reported measures of diabetes care with measures derived from medical records in a well-defined population. Diabetes measures were collected through a 1997 Behavioral Risk Factor Surveillance System telephone survey of American Indians living on or near 7 Montana reservations (N = 398) and were compared with data collected from charts of a systematic sample of American Indians with diabetes seen in 1997 at Indian Health Service (IHS) facilities. Survey respondents were more likely to report a duration of diabetes >10 years (44 vs 31%), annual dilated retinal exam (75 vs 59o), and an influenza immunization in the past year (73 vs 57%) compared with estimates from the chart audit. Estimates of pneumococcal immunization (88 vs 42%), annual cholesterol screening (86 vs 69o), and overweight, based on body mass index (67 vs 50%), were significantly higher from the chart audit. No significant differences were found between the survey respondents and the chart audit data for annual foot exams (65 vs 61%), annual blood pressure checks (98 vs 93%), high cholesterol (35 vs 41%), and high blood pressure (54 vs 64%). These findings suggest that self-reported data may over and underestimate specific measures of diabetes care.

Key Words: Adult • cardiovascular diseases/epidemiology • crosssectional studies • diabetes mellitus • health surveys • population surveillance • questionnaires/standards

American Journal of Medical Quality, Vol. 16, No. 1, 3-8 (2001)
DOI: 10.1177/106286060101600102


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