title: Validity of self-reported eye disease and treatment in a population-based study: the Los Angeles Latino Eye Study.
abstract: OBJECTIVE
  To examine the validity of self-reported eye disease, including cataract, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR), and self-reported surgical treatment for cataract and DR in the Los Angeles Latino Eye Study (LALES).
  
  
  METHODS
  Population-based, cross-sectional study.
  
  
  METHODS
  A total of 6357 Latinos aged 40+ years from the LALES.
  
  
  METHODS
  Participants underwent a detailed interview, including survey questions about ocular health, diagnoses, and timing of last eye examination, and a standardized clinical examination. Self-report was compared with examination to determine sensitivity and specificity by length of time since last eye examination. Stepwise logistic regression was used to determine factors associated with inaccurate self-report.
  
  
  METHODS
  Sensitivity and specificity were calculated for 4 self-reported eye diseases (cataract, AMD, glaucoma, and DR) and for surgical treatment of cataract and DR. Odds ratios (ORs) were determined for factors associated with inaccurate self-report underestimating eye disease and treatment.
  
  
  RESULTS
  For each disease, sensitivity and specificity in those who reported their last eye examination as <1 year ago were 36.8% and 92.5% for cataract, 37.7% and 96.3% for glaucoma, 5.1% and 98.9% for AMD, and 25.7% and 94.2% for DR, respectively. Self-report was less accurate with increasing time since last eye examination. Inaccurate self-report was independently associated with better visual acuity (OR, 2.4), <2 comorbidities (OR, 1.7), last eye examination/visit 1 to 5 years ago and ≥ 5 years ago (OR, 2.3 and 4.9, respectively), and less education (OR, 1.3 for 7-12 years and 1.7 for <7 years). Of 88 participants surgically treated for cataract who reported an eye examination <1 year ago, sensitivity and specificity of self-reported surgical history were 90.9% and 99.9%, respectively. Of the 31 participants treated for DR (laser/surgery) and reporting an eye examination <1 year ago, sensitivity and specificity of self-reported surgical history were 19.4% and 99.6%, respectively.
  
  
  CONCLUSIONS
  Among Latinos, self-reporting of eye disease and surgical history provides a significant underestimate of the disease burden. This may lead to significant misclassification in vision research if self-report alone is used to identify persons with eye disease.
authors.affiliation: Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Patty
authors.forename: Cathy
authors.initials: C
authors.lastname: Wu
authors.forename: Mina
authors.initials: M
authors.lastname: Torres
authors.forename: Stanley
authors.initials: S
authors.lastname: Azen
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
mesh_terms: D002386:Cataract / Q000208:ethnology; D002387:Cataract Extraction; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003930:Diabetic Retinopathy / Q000208:ethnology / Q000601:surgery; D005128:Eye Diseases / Q000208:ethnology* / Q000601:surgery*; D005901:Glaucoma / Q000208:ethnology; D006306:Health Surveys; D006630:Hispanic or Latino / Q000208:ethnology*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008268:Macular Degeneration / Q000208:ethnology; D010808:Physical Examination / Q000706:statistics & numerical data; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014787:Vision Tests / Q000706:statistics & numerical data; D014792:Visual Acuity / Q000502:physiology