title: Validity and reliability of self-reported diabetes in the Atherosclerosis Risk in Communities Study.
abstract: The objective of this study was to assess the validity of prevalent and incident self-reported diabetes compared with multiple reference definitions and to assess the reliability (repeatability) of a self-reported diagnosis of diabetes. Data from 10,321 participants in the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 4 (1996-1998) were analyzed. Prevalent self-reported diabetes was compared with reference definitions defined by fasting glucose and medication use obtained at visit 4. Incident self-reported diabetes was assessed during annual follow-up telephone calls and was compared with reference definitions defined by fasting glucose, hemoglobin A1c, and medication use obtained during an in-person visit attended by a subsample of participants (n = 1,738) in 2004-2005. The sensitivity of prevalent self-reported diabetes ranged from 58.5% to 70.8%, and specificity ranged from 95.6% to 96.8%, depending on the reference definition. Similarly, the sensitivity of incident self-reported diabetes ranged from 55.9% to 80.4%, and specificity ranged from 84.5% to 90.6%. Percent positive agreement of self-reported diabetes during 9 years of repeat assessments ranged from 92.7% to 95.4%. Both prevalent self-reported diabetes and incident self-reported diabetes were 84%-97% specific and 55%-80% sensitive as compared with reference definitions using glucose and medication criteria. Self-reported diabetes was >92% reliable over time.
authors.affiliation: Department of Epidemiology Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA. andrea.christman@gmail.com
authors.forename: Andrea L C
authors.initials: AL
authors.lastname: Schneider
authors.forename: James S
authors.initials: JS
authors.lastname: Pankow
authors.forename: Gerardo
authors.initials: G
authors.lastname: Heiss
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
mesh_terms: D000465:Algorithms; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003153:Community Health Services; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D005215:Fasting; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D057566:Self Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human