Reliability and sensitivity of the self-report of physician-diagnosed gout in the campaign against cancer and heart disease and the atherosclerosis risk in the community cohorts.
OBJECTIVE
gout is often defined by self-report in epidemiologic studies. Yet the validity of self-reported gout is uncertain. We evaluated the reliability and sensitivity of the self-report of physician-diagnosed gout in the Campaign Against Cancer and Heart Disease (CLUE II) and the Atherosclerosis Risk in the Community (ARIC) cohorts.


METHODS
the CLUE II cohort comprises 12,912 individuals who self-reported gout status on either the 2000, 2003, or 2007 questionnaires. We calculated reliability as the percentage of participants reporting having gout on more than 1 questionnaire using Cohen's κ statistic. The ARIC cohort comprises 11,506 individuals who self-reported gout status at visit 4. We considered a hospital discharge diagnosis of gout or use of a gout-specific medication as the standard against which to calculate the sensitivity of self-reported, physician-diagnosed gout.


RESULTS
of the 437 CLUE II participants who self-reported physician-diagnosed gout in 2000, and subsequently answered the 2003 questionnaire, 75% reported gout in 2003 (κ = 0.73). Of the 271 participants who reported gout in 2000, 73% again reported gout at the 2007 followup questionnaire (κ = 0.63). In ARIC, 196 participants met the definition for gout prior to visit 4 and self-reported their gout status at visit 4. The sensitivity of a self-report of physician-diagnosed gout was 84%. Accuracy was similar across sex and race subgroups, but differed across hyperuricemia and education strata.


CONCLUSIONS
these 2 population-based US cohorts suggest that self-report of physician-diagnosed gout has good reliability and sensitivity. Thus, self-report of a physician diagnosis of gout is appropriate for epidemiologic studies.
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21224, USA. agelber@jhmi.edu
Mara A
MA
McAdams
Janet W
JW
Maynard
Alan N
AN
Baer
Anna
A
Köttgen
Sandra
S
Clipp
Josef
J
Coresh
Allan C
AC
Gelber
D050197:Atherosclerosis / Q000453:epidemiology / Q000503:physiopathology; D015331:Cohort Studies; D016021:Epidemiologic Studies; D005260:Female; D006073:Gout / Q000175:diagnosis* / Q000453:epidemiology*; D006331:Heart Diseases / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D010820:Physicians; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires