Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure.
OBJECTIVE
Questionnaires are used to estimate disease burden. Agreement between questionnaire responses and a criterion standard is important for optimal disease prevalence estimates. We measured the agreement between self-reported disease and medical record diagnosis of disease.


METHODS
A total of 2,037 Olmsted County, Minnesota residents > or =45 years of age were randomly selected. Questionnaires asked if subjects had ever had heart failure, diabetes, hypertension, myocardial infarction (MI), or stroke. Medical records were abstracted.


RESULTS
Self-report of disease showed >90% specificity for all these diseases, but sensitivity was low for heart failure (69%) and diabetes (66%). Agreement between self-report and medical record was substantial (kappa 0.71-0.80) for diabetes, hypertension, MI, and stroke but not for heart failure (kappa 0.46). Factors associated with high total agreement by multivariate analysis were age <65 years, female sex, education >12 years, and zero Charlson Index score (P < .05).


CONCLUSIONS
Questionnaire data are of greatest value in life-threatening, acute-onset diseases (e.g., MI and stroke) and chronic disorders requiring ongoing management (e.g.,diabetes and hypertension). They are more accurate in young women and better-educated subjects.
Okura
Yuji
Y
Division of Cardiovascular Diseases and Internal Medicine, Department of Health Science Research, Mayo Clinic and Foundation, 200 First St SW, Rochester, Minnesota 55905, USA.
Urban
Lynn H
LH
Mahoney
Douglas W
DW
Jacobsen
Steven J
SJ
Rodeheffer
Richard J
RJ
D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000523:psychology; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000523:psychology; D018450:Disease Progression; D004522:Educational Status; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000523:psychology; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis / Q000523:psychology; D011795:Surveys and Questionnaires