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Reliability of patient-reported comorbidities: a systematic review and meta-analysis
  1. Chung Mun Alice Lin1,
  2. Nathan Ng2,
  3. Alexander Orman1,
  4. Nicholas D Clement2,3,
  5. David J Deehan3
  1. 1Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
  2. 2Department of Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3Musculoskeletal Department, Freeman Hospital, Newcastle upon Tyne, UK
  1. Correspondence to Dr Chung Mun Alice Lin, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; ncmal{at}


Self-reported questionnaires have become a widely adopted method of reviewing patients in clinical practice. This systematic review aimed to determine the reliability of patient-reported comorbidities and to identify which patient factors influence the reliability. Included studies assessed the reliability of at least one patient-reported comorbidity against their medical record or clinical assessment as gold standard. Twenty-four eligible studies were included in the meta-analysis. Only endocrine diseases (Cohen's Kappa Coefficient (CKC) 0.81 (95% CI 0.76 to 0.85)), consisting of diabetes mellitus (CKC 0.83 (95% CI 0.80 to 0.86)) and thyroid disease (CKC 0.68 (95% CI 0.50 to 0.86)), showed good-to-excellent reliability. Factors most frequently reported to influence concordance included age, sex and educational level.

This systematic review demonstrated poor-to-moderate reliability for most systems, except for endocrine which showed good-to-excellent reliability. Although patient self-reporting can be a useful guide to clinical management, several patient factors were demonstrated to affect reliability therefore it should be avoided as a standalone measure.

  • general medicine
  • health services administration & management
  • internal medicine
  • medical education & training
  • surgery

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  • Contributors CMAL performed the article screening, data extraction, analysis, write up and revision of this manuscript. NN performed the meta-analysis, contributed to the write up process and revised the manuscript. AO contributed to the article screening process and data extraction and revised the manuscript. NDC contributed to the design of the project and to the writing and revision of the manuscript. DJD was responsible for the design of the project and finalised the manuscript. All authors approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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