Document Detail

Validation of self-report of rheumatoid arthritis and systemic lupus erythematosus: The Women's Health Initiative.
MedLine Citation:
PMID:  18398940     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The Women's Health Initiative (WHI), initiated in 1993, enrolled 161,808 postmenopausal women aged 50-79 years and followed them with annual questionnaires for 8 years in order to study major causes of morbidity and mortality. Our objective was to determine the most effective and efficient means to validate self-reported rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in the WHI.
METHODS: Data from 2 of 40 WHI clinical centers were used. Of these 7443 women, 643 self-reported RA and 106 self-reported SLE. Research coordinators contacted these women using mailers and telephone calls to obtain medical record releases and a Connective Tissue Screening Questionnaire (CSQ). Medical records were obtained on 286 self-reported RA and 34 self-reported SLE and reviewed by 3 rheumatologists blind to the self-reported diagnoses. Sensitivity, specificity, and the kappa statistic were computed to evaluate the level of agreement between self-report and chart review.
RESULTS: Self-reported RA was accurate only 14.7% (42/286 cases) of the time. Coupling the self-report to medication data improved the positive predictive value (PPV; 62.2%) and kappa (0.53), suggesting a moderate agreement to chart review. Self-reported SLE was accurate only 11.8% (4/34 cases) of the time. Coupling the self-report to medication data improved the PPV (40.0%) and kappa (0.44), suggesting a moderate agreement to chart review. The CSQ was inferior to using medication data but was substantially better than self-report alone.
CONCLUSION: The performance of disease self-report coupled with medication history in validating RA and SLE was very good and should obviate the need for time-consuming medical record reviews.
Brian T Walitt; Florina Constantinescu; James D Katz; Arthur Weinstein; Hong Wang; Rohini K Hernandez; Judith Hsia; Barbara V Howard
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2008-04-01
Journal Detail:
Title:  The Journal of rheumatology     Volume:  35     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-08     Completed Date:  2008-08-21     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  811-8     Citation Subset:  IM    
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MeSH Terms
Arthritis, Rheumatoid / diagnosis*
Health Surveys*
Lupus Erythematosus, Systemic / diagnosis*
Middle Aged
Self Disclosure*
Sensitivity and Specificity
Single-Blind Method
Women's Health*
Grant Support
N01 WH022110/WH/WHI NIH HHS; N01 WH022110-024/WH/WHI NIH HHS

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