Misclassification and under-reporting of acute myocardial infarction by elderly persons: implications for community-based observational studies and clinical trials.
We investigated the accuracy of self-report of hospitalization for acute myocardial infarction (MI) by elderly persons in a community-based prospective study. Among 3809 persons aged 65 years or older followed up for 6 years, self-reported hospitalization for MI was validated by review of primary records and Medicare diagnoses. Among 147 who self-reported MI and for whom hospital records were available, the diagnosis was confirmed in 79 (54%). Myocardial infarction was not a reason for hospitalization among the remaining 68 participants; misclassification with other cardiovascular diagnoses was common. Medicare diagnosis correlated well with primary hospital records. Using Medicare diagnoses as the standard, the diagnosis of MI was confirmed in 53% of self-reports; the sensitivity and specificity of self-report were 51% and 98%, respectively. False-negative reporting was common because only half of hospitalizations for MI were reported. Self-report of hospitalization for MI by elderly persons in the community may be unreliable for ascertaining trends in cardiovascular diseases.
O'Donnell
C J
CJ
Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA.
Glynn
R J
RJ
Field
T S
TS
Averback
R
R
Satterfield
S
S
Friesenger
G C
GC
Taylor
J O
JO
Hennekens
C H
CH
D000368:Aged; D001900:Boston / Q000453:epidemiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D006278:Medicare; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology; D015588:Observer Variation; D011159:Population Surveillance; D011446:Prospective Studies; D015203:Reproducibility of Results; D012650:Self Disclosure; D012680:Sensitivity and Specificity; D014481:United States