Validation of self-reported chronic conditions and health services in a managed care population.
BACKGROUND
Self-reported data are commonly used to estimate the prevalence of health conditions and the use of preventive health services in the population, but the validity of such data is often questioned.


METHODS
The Behavioral Risk Factor Survey (BRFS) was admin istered by telephone to a stratified, random sample of health maintenanc e organization (HMO) subscribers in Colorado in 1993, and self-reports w ere compared with HMO medical records for 599 adults aged >21. Sensitivity and specificity were calculated for three chronic conditions and use of six preventive services.


RESULTS
Sensitivity was highest for hypertension (83%), moderate for diabetes (73%), and lowest for hypercholesterolemia (59%); specificity was >80% for all three conditions. Sensitivity ranged from 86% to 99% for influenza immunization, clinical breast examination, blood cholesterol screening, mammography, Pap test, and blood pressure screening; specificity was <75% for all preventive services.


CONCLUSIONS
Self-reports are reasonably accurate for certain chronic conditions and for routine screening exams and can provide a useful estimate for broad measures of population prevalence.
Martin
L M
LM
Division of Public Health, Georgia Department of Human Resources, Atlanta, Georgia, USA. lmmartin@dhr.state.ga.us
Leff
M
M
Calonge
N
N
Garrett
C
C
Nelson
D E
DE
D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000453:epidemiology*; D003120:Colorado; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008875:Middle Aged; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012650:Self Disclosure