Agreement of injury reporting between primary care medical record and maternal interview for children aged 0-3 years: implications for research and clinical care.
ABSTRACT To assess agreement of injury reporting between primary care medical record and maternal interview.
Cross-sectional study of data from a randomized controlled trial of home visiting. The setting was Hawaii's Healthy Start Program (HSP). Subjects comprised a population-based sample of children in at-risk families with 3 years of primary care medical records and maternal interviews (n = 443). Outcome measures were percentage of children injured unintentionally and mean number of injuries per child in the first 3 years of life by primary care medical record and maternal interview.
We identified 490 injuries: 48% by primary care medical record, 22% by maternal interview, and 30% in both sources. More children were reported injured by primary care medical record than maternal interview (51% vs 39%, P< .001). The mean number of injuries per child was 0.87 by primary care medical record and 0.51 by maternal interview (difference 0.36, 95% confidence interval 0.27-0.45, P< .001). Agreement between data sources was fair (kappa = 0.47).
This study estimates that 25% of childhood injuries may not be reported in the medical record, highlighting the need for reconsideration of the use of medical records as the gold standard for unintentional injury data. Caution should be used when interpreting injury data from one source, especially from families with stressful life situations. Poor communication regarding injuries between social service, primary care and urgent care providers may contribute to decreased quality of primary care and missed opportunities for injury prevention.
Article: Psychometric Characteristics of a Measure of Emotional Dispositions Developed to Test a Developmental Propensity Model of Conduct Disorder[show abstract] [hide abstract]
ABSTRACT: Lahey and Waldman proposed a developmental propensity model in which three dimen-sions of children's emotional dispositions are hypothesized to transact with the environ-ment to influence risk for conduct disorder, heterogeneity in conduct disorder, and comorbidity with other disorders. To prepare for future tests of this model, a new mea-sure of these dispositions was tested. Exploratory factor analysis of potential items was conducted in a sample of 1,358 participants 4 to 17 years of age. Confirmatory factor analyses then confirmed the three dispositional dimensions in a second sample of 2,063 pairs of 6-to 17-year-old twins. Caretaker ratings of the dispositional dimensions were associated as predicted with symptoms of conduct disorder and other psychopath-ology. In a third sample, caretaker ratings of each disposition correlated uniquely with relevant observational measures of child behavior and unintentional injuries. These findings provide initial support for the new dispositional measure.Journal of Clinical Child & Adolescent Psychology 01/2008; 37:794-807. · 1.92 Impact Factor