title: Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure.
abstract: 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.
authors.affiliation: Division of Cardiovascular Diseases and Internal Medicine, Department of Health Science Research, Mayo Clinic and Foundation, 200 First St SW, Rochester, Minnesota 55905, USA.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Okura
authors.forename: Lynn H
authors.initials: LH
authors.lastname: Urban
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Mahoney
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rodeheffer
mesh_terms: 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