title: Misclassification and under-reporting of acute myocardial infarction by elderly persons: implications for community-based observational studies and clinical trials.
abstract: 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.
authors.affiliation: Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: R J
authors.initials: RJ
authors.lastname: Glynn
authors.forename: T S
authors.initials: TS
authors.lastname: Field
authors.forename: R
authors.initials: R
authors.lastname: Averback
authors.forename: S
authors.initials: S
authors.lastname: Satterfield
authors.forename: G C
authors.initials: GC
authors.lastname: Friesenger
authors.forename: J O
authors.initials: JO
authors.lastname: Taylor
authors.forename: C H
authors.initials: CH
authors.lastname: Hennekens
mesh_terms: 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