Document Detail


Magnitude and consequences of misclassification of incident hip fractures in large cohort studies: the Study of Osteoporotic Fractures and Medicare claims data.
MedLine Citation:
PMID:  23208073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Prospective cohort studies of fractures that rely on participant self-report to be the initial signal of an incident fracture could be prone to bias if a significant proportion of fractures are not self-reported.
METHODS: We used data from the SOF merged with Medicare Fee-for-Service claims data to estimate the proportion of participants who had an incident hip fracture identified in Medicare claims that was either not self-reported or confirmed (by review of radiographic reports) in SOF.
RESULTS: Between 1/1/1991 and 12/31/2007, 647 SOF participants had a hip fracture identified in Medicare claims, but 120 (18.5 %) were either not reported to or confirmed by the cohort. False-negative hip fracture ascertainment was associated with a reduced modified Mini-Mental State Exam (MMSE) score (odds ratio 1.31 per SD decrease, 95 % C.I. 1.06-1.63). Point estimates of associations of predictors of incident hip fracture were changed minimally when the misclassification of incident hip fracture status was corrected with use of claims data.
CONCLUSIONS: A substantial minority of incident hip fractures were not reported to or confirmed in the SOF. Cognitive impairment was modestly associated with false-negative hip fracture ascertainment. While there was no evidence to suggest that misclassification of incident hip fracture status resulted in biased associations of potential predictors with hip fracture in this study, false-negative incident fracture ascertainment in smaller cohort studies with limited power may increase the risk of type 2 error (not finding significant associations of predictors with incident fractures).
Authors:
J T Schousboe; M L Paudel; B C Taylor; B A Virnig; J A Cauley; J R Curtis; K E Ensrud
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2012-12-04
Journal Detail:
Title:  Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA     Volume:  24     ISSN:  1433-2965     ISO Abbreviation:  Osteoporos Int     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-14     Completed Date:  2013-08-13     Revised Date:  2014-03-07    
Medline Journal Info:
Nlm Unique ID:  9100105     Medline TA:  Osteoporos Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-10     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Bone Density / physiology
Cognition Disorders / psychology
Cohort Studies
False Negative Reactions
Female
Femur Neck / physiopathology
Hip Fractures / classification,  diagnosis,  epidemiology*,  physiopathology
Humans
Incidence
Medicare / statistics & numerical data
Osteoporotic Fractures / classification,  diagnosis,  epidemiology*,  physiopathology
Psychiatric Status Rating Scales
Risk Factors
Self Report
United States / epidemiology
Grant Support
ID/Acronym/Agency:
AR053351/AR/NIAMS NIH HHS; K23 AR053351/AR/NIAMS NIH HHS; R01 AG005394/AG/NIA NIH HHS; R01 AG005394/AG/NIA NIH HHS; R01 AG005407/AG/NIA NIH HHS; R01 AG005407/AG/NIA NIH HHS; R01 AG027574/AG/NIA NIH HHS; R01 AG027574/AG/NIA NIH HHS; R01 AG027576/AG/NIA NIH HHS; R01 AG027576/AG/NIA NIH HHS; R01 AG038415/AG/NIA NIH HHS; R01 AR035582/AR/NIAMS NIH HHS; R01 AR035583/AR/NIAMS NIH HHS; R01 AR035584/AR/NIAMS NIH HHS; R01 AR35582/AR/NIAMS NIH HHS; R01 AR35583/AR/NIAMS NIH HHS; R01 AR35584/AR/NIAMS NIH HHS; R01 HS018517/HS/AHRQ HHS; R01HS018517/HS/AHRQ HHS
Comments/Corrections

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