Is patient self-report an adequate tool for monitoring cardiovascular conditions in patients with hypercholesterolemia?
BACKGROUND
To determine the accuracy of patient self-reports of specific cardiovascular diagnoses and to identify individual patient characteristics that influence the accuracy.


METHODS
This investigation was conducted as a part of the randomized controlled ORBITAL study. Patients with hypercholesterolemia were enrolled in 1961 primary-care centers all over Germany. Self-reported questionnaire data of 7640 patients were compared with patients' case report forms (CRFs) and medical records on cardiovascular diseases, using kappa statistics and binomial logit models.


RESULTS
kappa values ranged from 0.89 for diabetes to 0.04 for angina. The percentage of overreporting varied from 1% for diabetes to 17% for angina, whereas the percentage of underreporting varied from 8.0% for myocardial infarction to 57% for heart failure. Individual characteristics such as choice of individual general practitioner, male gender and age were associated with the accuracy of self-report data.


CONCLUSIONS
Since the agreement between patient self-report and CRFs/medical records varies with specific cardiovascular diagnoses in patients with hypercholesterolemia, the adequacy of this tool seems to be limited. However, the authors recommend additional data validation for certain patient groups and consideration of individual patient characteristics associated with over- and underreporting.
Englert
Heike
H
Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany. englert@fh-muenster.de
Müller-Nordhorn
Jacqueline
J
Seewald
Sebastian
S
Sonntag
Frank
F
Völler
Heinz
H
Meyer-Sabellek
Wolfgang
W
Wegscheider
Karl
K
Windler
Eberhard
E
Katus
Hugo
H
Willich
Stefan N
SN
D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D005260:Female; D005858:Germany; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010821:Physicians, Family; D015203:Reproducibility of Results; D012650:Self Disclosure; D011795:Surveys and Questionnaires