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Validity of Patient Self-reported History of Skin Cancer
Michael E. Ming, MD, MSCE;
Ross M. Levy, MD;
Ole J. Hoffstad, MA;
Jennifer Filip, BA;
Phyllis A. Gimotty, PhD;
David J. Margolis, MD, PhD
Arch Dermatol. 2004;140:730-735.
Objective To determine the validity of patient self-report of skin cancer history.
Design A cohort of patients was randomly selected from the case group in a prior case-control study involving skin cancer, and a second cohort was randomly selected from the controls of that study. Patient self-reported history (as determined by responses to a survey) was compared with the gold standard of chart documentation of a pathology report or a procedure note from Mohs micrographic surgery demonstrating skin cancer.
Setting University-based outpatient dermatology clinic.
Patients Three hundred patients were selected.
Main Outcome Measures Patients were considered to have correctly classified their skin cancer history if their self-reported history was consistent with chart documentation.
Results We obtained chart information for 258 patients.Of those patients, 183 (70.9%) had chart documentation of nonmelanoma skin cancer, and 16 (6.2%) had chart documentation of a melanoma. Using chart documentation as the gold standard, we found that patients correctly identified their basal cell carcinoma status in 84.3% of cases; their squamous cell carcinoma status in 81.5% of cases; their overall nonmelanoma skin cancer status in 91.8% of cases; their melanoma status in 94.8% of cases; and their overall skin cancer status in 92.6% of cases. Patients' self-reported history of skin cancer of any type had a positive predictive value of 95.1% and a negative predictive value of 85.9%.
Conclusions Self-reported history of skin cancer had a high degree of sensitivity and specificity and a high positive and negative predictive value within the study population. Obtaining medical information by patient report appears to be a useful tool for determining medical history of skin cancer.
From the Departments of Dermatology (Drs Ming, Levy, and Margolis) and Biostatistics and Epidemiology (Drs Gimotty and Margolis, Mr Hoffstad, and Ms Filip), University of Pennsylvania School of Medicine, Philadelphia. The authors have no relevant financial interest in this article.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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