Agreement between upper respiratory diagnoses from self-report questionnaires and medical records in an occupational health setting

Background The Fire Department of the City of New York World Trade Center Health Program (FDNY‐WTCHP) monitors and treats WTC‐related illnesses through regular physical exams, self‐administered health questionnaires and treatment visits, as indicated. Methods We measured positive and negative predictive values (PPV, NPV) of self‐reported diagnoses of GERD and rhinosinusitis from the health questionnaires in relation to FDNY physician diagnoses from the medical record. Results Self‐reported GERD had PPV and NPV of 54.0% and 95.7%, respectively; for rhinosinusitis, the PPV and NPV were 48.2% and 91.9%. These characteristics improved considerably (PPV 78.0% GERD and PPV 76.5% rhinosinusitis) in a subpopulation receiving medications from the FDNY‐WTCHP. Conclusion The PPV of self‐reported diagnoses demonstrates only modest value in predicting physician diagnoses, although high NPVs suggest benefit in ruling out disease. In subgroups selected for their higher disease prevalence, self‐reported diagnoses may be considerably more useful. Am. J. Ind. Med. 57:1181–1187, 2014. © 2014 Wiley Periodicals, Inc.