title: Agreement between self-report of disease diagnoses and medical record validation in disabled older women: factors that modify agreement.
abstract: OBJECTIVE
  To determine the agreement between self-report of chronic disease and validated evidence of disease using multiple ascertainment methods and to assess effects of cognition, education, age, and comorbidity.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Community Baltimore, Maryland.
  
  
  METHODS
  One thousand two community-dwelling disabled women aged 65 and older.
  
  
  METHODS
  Kappa statistics were calculated to determine the relationship between self-report of 14 diseases and standardized algorithms. Analyses were stratified using Mini-Mental State Examination score, education, number of chronic diseases, and age.
  
  
  RESULTS
  Kappa was excellent for hip fracture (HF), Parkinson's disease (PD), diabetes mellitus (DM), cancer, stroke, and disc disease (DD); fair to good for angina pectoris, congestive heart failure, and myocardial infarction; and poor for peripheral arterial disease, spinal stenosis, osteoporosis, arthritis, and lung disease. Overall, kappa decreased with decreasing cognition and education, increasing age, and four or more diseases.
  
  
  CONCLUSIONS
  In disabled older women, self-report of physician diagnosis of HF, PD, DM, cancer, stroke, and DD appears valid. In general, increasing comorbidity and age and decreasing cognition and education do not reduce validity for diseases where agreement was excellent overall.
authors.affiliation: Center on Aging and Health Division of Geriatric Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. cfsimpson@jhmi.edu
authors.forename: Crystal F
authors.initials: CF
authors.lastname: Simpson
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Boyd
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Carlson
authors.forename: Michael E
authors.initials: ME
authors.lastname: Griswold
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015142:Baltimore / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008499:Medical Records; D011446:Prospective Studies; D012650:Self Disclosure