Moderate agreement between self-reported stroke and hospital-recorded stroke in two cohorts of Australian women: a validation study

BMC Medical Research Methodology

Annette Dobson²  Julie Byles¹  Leigh Tooth²  Gita D Mishra²  Caroline A Jackson² 

[1] Research Centre for Gender, Health and Ageing, University of Newcastle, Callaghan, NSW 2308, Australia;Centre for Longitudinal and Life Course Research, School of Public Health, University of Queensland, Herston QLD 4006, Australia

关键词: Hospitalisation;    Self-report;    Validation studies;    Cerebrovascular disease;    Stroke;    Epidemiology;   

Others  :  1109651
DOI  :  10.1186/1471-2288-15-7

 received in 2014-04-08, accepted in 2015-01-15,  发布年份 2015

【 摘 要 】

Background

Conflicting findings on the validity of self-reported stroke from existing studies creates uncertainty about the appropriateness of using self-reported stroke in epidemiological research. We aimed to compare self-reported stroke against hospital-recorded stroke, and investigate reasons for disagreement.

Methods

We included participants from the Australian Longitudinal Study on Women’s Health born in 1921–26 (n = 1556) and 1946–51 (n = 2119), who were living in New South Wales and who returned all survey questionnaires over a defined period of time. We determined agreement between self-reported and hospitalised stroke by calculating sensitivity, specificity and kappa statistics. We investigated whether characteristics including age, education, area of residence, country of birth, language spoken at home, recent mental health at survey completion and proxy completion of questionnaire were associated with disagreement, using logistic regression analysis to obtain odds ratios (ORs) with 95% confidence intervals (CIs).

Results

Agreement between self-report and hospital-recorded stroke was fair in older women (kappa 0.35, 95% CI 0.25 to 0.46) and moderate in mid-aged women (0.56, 95% CI 0.37 to 0.75). There was a high proportion with unverified self-reported stroke, partly due to: reporting of transient ischaemic attacks; strokes occurring outside the period of interest; and possible reporting of stroke-like conditions. In the older cohort, a large proportion with unverified stroke had hospital records of other cerebrovascular disease. In both cohorts, higher education was associated with agreement, whereas recent poor mental health was associated with disagreement.

Conclusion

Among women who returned survey questionnaires within the period of interest, validity of self-reported stroke was fair to moderate, but is probably underestimated. Agreement between self-report and hospital-recorded stroke was associated with individual characteristics. Where clinically verified stroke data are unavailable, self-report may be a reasonable alternative method of stroke ascertainment for some epidemiological studies.

【 授权许可】

   
2015 Jackson et al.; licensee BioMed Central.

【 图 表 】

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