Document Detail


Validity of self-report for fractures among a multiethnic cohort of postmenopausal women: results from the Women's Health Initiative observational study and clinical trials.
MedLine Citation:
PMID:  15167305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study is to examine the validity of, and factors associated with, the accuracy of self-report (participant-report and proxy-report) for fractures. DESIGN: Study participants were from the Women's Health Initiative Clinical Trial and Observational Study cohorts. All women were postmenopausal; populations included American Indian, Asian/Pacific Islander, black, Hispanic, and non-Hispanic white. The average length of follow-up was 4.3 years. Self-reported fractures were adjudicated by reviewing medical records. The first adjudicated self-report of fractures for each participant was included in the analysis (n = 6,652). RESULTS: We found substantial variations in validity of self-report by the fracture site. Agreements between self-reports for single-site fractures and medical records were high for hip (78%) and forearm/wrist (81%) but relatively lower for clinical spine fractures (51%). The average confirmation rate for all single-site fractures was 71%. Misidentification of fracture sites by participants or proxy-reporters seemed to be a cause of unconfirmed self-reports. Higher confirmation rates were observed in participant-reports than in proxy-reports. Results of the multivariate analysis indicated that multiple factors, such as ethnicity, a history of osteoporosis or fractures, body mass index, years since menopause, smoking status, and number of falls in the past year were significantly (P < 0.05) related to the validity of self-report. CONCLUSION: The validity of self-reports for fracture varies by fracture sites and many other factors. The assessed validity in this study is likely conservative because some of the unconfirmed self-reports may be due to poor medical record systems. The validity of self-reports for hip and forearm/wrist fractures is high in this study, supporting their use in epidemiological studies among postmenopausal women.
Authors:
Zhao Chen; Charles Kooperberg; Mary B Pettinger; Tamsen Bassford; Jane A Cauley; Andrea Z LaCroix; Cora E Lewis; Simon Kipersztok; Carolyn Borne; Rebecca D Jackson
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Validation Studies    
Journal Detail:
Title:  Menopause (New York, N.Y.)     Volume:  11     ISSN:  1072-3714     ISO Abbreviation:  Menopause     Publication Date:    2004 May-Jun
Date Detail:
Created Date:  2004-05-28     Completed Date:  2004-08-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9433353     Medline TA:  Menopause     Country:  United States    
Other Details:
Languages:  eng     Pagination:  264-74     Citation Subset:  IM    
Affiliation:
University of Arizona, Tucson, AZ, USA. zchen@u.arizona.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Ethnic Groups*
Female
Fractures, Bone / epidemiology*,  ethnology,  etiology,  radiography
Humans
Medical Records
Middle Aged
Osteoporosis, Postmenopausal / epidemiology*,  ethnology,  etiology,  radiography
Postmenopause
Questionnaires / standards*
Reproducibility of Results
Retrospective Studies
United States / epidemiology
Grant Support
ID/Acronym/Agency:
1 K01 AR02060/AR/NIAMS NIH HHS; N-01-WH-3-2115/WH/WHI NIH HHS
Comments/Corrections
Comment In:
Menopause. 2004 May-Jun;11(3):244-5   [PMID:  15167302 ]

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