Reproducibility of medical information obtained via the telephone vs personal interview.

: The Motherisk [corrected] Program, a teratogenic information service, conducts patient interviews over the telephone as well as in a clinic setting. In both instances, medical information and exposure history is obtained from the patient, including such items as pregnancy history, drug exposure, alcohol and smoking habits. It occurred on several occasions that the clinic interviewer remarked that the same patient had volunteered information to them, that differed from the information documented on the intake telephone form. The objective of the study was to establish the levels of agreement in the documentation, between these two forms of interviews. Two groups of 100 paired telephone and clinic forms were randomly selected from our data base, 1990-1991 and 1996-1997. These two groups were chosen to assess if there were any differences over a five year time period. Statistical calculations were performed using the Kappa statistic, a method that measures agreement. Kappa scores indicated high reproducibility for both pregnancy and smoking history, good reproducibility for medical history, marginal-good for exposures (although excellent agreement was found for the primary drug of concern) and marginal-good for alcohol information. Overall, agreement was superior in the 1990-1991 group. There were marked differences in consistency, between the information recorded on the telephone form and the clinic form, most specifically relating to secondary exposures and alcohol history. It suggests that a person to person interview yields a more complete medical history than a telephone interview.