Medical record validation of self-reported eye diseases and eye care utilization among older adults.
OBJECTIVE
Vision impairment is an important public health concern. Accurate information regarding visual health and eye care utilization is essential to monitor trends and inform health policy interventions aimed at addressing at-need populations. National surveys provide annual prevalence estimates but rely on self-report. The validity of self-reported information regarding eye disease has not been adequately explored.


METHODS
This cross-sectional study compared self-report of eye care utilization and eye disease with information obtained from medical records. The study population was 2001 adults aged 70 years and older who completed the Behavioral Risk Factor Surveillance System's Visual Impairment and Access to Eye Care Module. Cohen's kappa (κ) was used to assess agreement.


RESULTS
Agreement between self-report and medical records was substantial for eye care utilization (κ = 0.64) and glaucoma (κ = 0.73), moderate for macular degeneration (κ = 0.40) and diabetic retinopathy (κ = 0.47) and slight for cataracts (κ = 0.18). Self-report tended to overestimate the number of subjects who visited an eye care provider in the previous year, and underestimated the prevalence in all but one (glaucoma) of the four eye diseases evaluated.


CONCLUSIONS
Though agreement was substantial for self-report of eye care utilization, results of the current study suggest that national estimates based on self-report overestimate eye care utilization.
Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294-0016, USA. pmac@uab.edu
Paul A
PA
MacLennan
Gerald
G
McGwin
Karen
K
Searcey
Cynthia
C
Owsley
D000368:Aged; D000369:Aged, 80 and over; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005128:Eye Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D015995:Prevalence; D012189:Retrospective Studies; D057566:Self Report; D014481:United States / Q000453:epidemiology