Kashner and coworkers sought to evaluate a telephone-operated, interactive voice response (IVR) system designed to collect use-of-care data from patients with major depression (UAC-IVR). Patient self-reports from repeated IVR surveys were compared with provider records for 3,789 patients with major depression at 41 clinical sites participating in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. UAC-IVR responses were examined for consistency and compared with provider records to compute reporting biases and intraclass correlation coefficients. Predictors of inconsistent responses and reporting biases were based on mixed logistic and regression models adjusted for need and predisposing and enabling covariates, and corrected for nesting and repeated measures. Inconsistent responses were found for 10% of calls and 21% of patients. Underreporting biases (-20%) and moderate agreement (intraclass correlation of 68%) were found when UAC-IVR responses were compared with medical records. IVR reporting biases were less for patients after three calls or more (experience), for patients with severe baseline symptoms (motivation), and for patients who gave consistent IVR responses (reliability). Bias was unrelated to treatment outcomes or demographic factors.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that clinical managers should use interactive voice response systems to collect service histories only after patients are properly trained and responses monitored for consistency and reporting biases.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Many patients with a chronic illness would like to be able to use an interactive voice response system to communicate with health care providers. As pointed out in this study, however, you need to be trained to use the system properly before it can be of value to you. Nevertheless, interactive voice response systems appear to be hold value for future studies of health care provider/patient interactions.

TM Kashner et al. Voice response system to measure healthcare costs: a STAR*D report.
American Journal of Managed Care, 2009;15:153-162.