Agreement between self-report and medical records on signs and symptoms of respiratory illness

Background: Information on patient symptoms can be obtained by patient self-report or medical records review. Both methods have limitations. Aims: To assess the agreement between self-report and documentation in the medical records of signs/symptoms of respiratory illness (fever, cough, runny nose, sore throat, headache, sinus problems, muscle aches, fatigue, earache, and chills). Methods: Respondents were 176 research participants in the Hutterite Influenza Prevention Study during the 2008-2009 influenza season with information about the presence or absence of signs/symptoms from both self-report and primary care medical records. Results: Compared with medical records, lower proportions of self-reported fever, sore throat, earache, cough, and sinus problems were found. Total agreements between self-report and medical report of symptoms ranged from 61% (for sore throat) to 88% (for muscle aches and earache), with kappa estimates varying from 0.05 (for chills) to 0.41 (for cough) and 0.51 (for earache). Negative agreement was considerably higher (from 68% for sore throat to 93% for muscle aches and earache) than positive agreement (from 13% for chills to 58% for earache) for each symptom except cough where positive agreement (77%) was higher than negative agreement (64%). Agreements varied by age group. We found better agreement for earache (kappa=0.62) and lower agreements for headache, sinus problems, muscle aches, fatigue, and chills in older children (aged =5 years) and adults. Conclusions: Agreements were variable depending on the specific symptom. Contrary to research in other patient populations which suggests that clinicians report fewer symptoms than patients, we found that the medical record captured more symptoms than selfreport. Symptom agreement and disagreement may be affected by the perspectives of the person experiencing them, the observer, the symptoms themselves, measurement error, the setting in which the symptoms were observed and recorded, and the broader community and cultural context of patients. © 2012 Primary Care Respiratory Society UK. All rights reserved.

Discourses of equality in post-Agreement Northern Ireland

This article analyses the use of equality as a concept central to the implementation of the 1998 Good Friday Agreement in Northern Ireland. The authors argue that, although equality legislation is succeeding in redressing previous discrimination in society, the discourses that have emerged around it have exacerbated competition and polarization between communities for two main reasons. Firstly, in " selling' the Agreement to their supporters, political elites have appropriated community-specific definitions of the concept, thus reinforcing rather than weakening group differences. Secondly, the practice of equality legislation involves the definitive categorization of individuals as members of particular groups. This article examines these processes and their effects through the analysis of the discourse of nationalist and Unionist Party elites and of individual Catholics and Protestants. This is done in order to capture the dynamics of change in political communication and identification rather than simply describing institutional alterations.

Keeping a sense of proportion but losing all perspective: a critique of Gorard's notion of the 'Politician's Error'

In 1999 Stephen Gorard published an article in this journal in which he provided a trenchant critique of what he termed the `politician's error' in analysing differences in educational attainment. The main consequence of this error, he argued, has been the production of misleading findings in relation to trends in educational performance over time that have, in turn, led to misguided and potentially damaging policy interventions. By using gender differences in educational attainment as a case study, this article begins by showing how Gorard's notion of the politician's error has been largely embraced and adopted uncritically by those within the field. However, the article goes on to demonstrate how Gorard's own preferred way of analysing such differences – by calculating and comparing proportionate changes in performance between groups – is also inherently problematic and can lead to the production of equally misleading findings. The article will argue that there is a need to develop a more reliable and valid way of measuring trends in educational performance over time and will show that one of the simplest ways of doing this is to make use of existing, and widely accepted, measures of effect size.

Improved data for solar flare X-ray spectral analysis

The inclusion of collisional rates for He-like Fe and Ca ions is discussed with reference to the analysis of solar flare Fe XXV and Ca XIX line emission, particularly from the Yohkoh Bragg Crystal Spectrometer (BCS). The new data are a slight improvement on calculations presently used in the BCS analysis software in that the discrepancy in the Fe XXV y and z line intensities (observed larger than predicted) is reduced. Values of electron temperature from satellite-to-resonance line ratios are slightly reduced (by up to 1 MK) for a given observed ratio. The new atomic data will be incorporated in the Yohkoh BCS databases. The data should also be of interest for the analysis of high-resolution, non-solar spectra expected from the Constellation-X and Astro-E space missions. A comparison is made of a tokamak S XV spectrum with a synthetic spectrum using atomic data in the existing software and the agreement is found to be good, so validating these data for particularly high-n satellite wavelengths close to the S XV resonance line. An error in a data file used for analyzing BCS Fe XXVI spectra is corrected, so permitting analysis of these spectra.

Error sensitive historical GIS: Identifying areal interpolation errors in time series data

Historical GIS has the potential to re-invigorate our use of statistics from historical censuses and related sources. In particular, areal interpolation can be used to create long-run time-series of spatially detailed data that will enable us to enhance significantly our understanding of geographical change over periods of a century or more. The difficulty with areal interpolation, however, is that the data that it generates are estimates which will inevitably contain some error. This paper describes a technique that allows the automated identification of possible errors at the level of the individual data values.