title: Validity of self-report in type 1 diabetic subjects for laser treatment of retinopathy.
abstract: OBJECTIVE
  This study sought to determine the validity of self-report of prior panretinal photocoagulation (PRP) and focal photocoagulation (FP) compared with fundus photography.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  One thousand three hundred sixty-three type 1 diabetic subjects from the Epidemiology of Diabetes Interventions and Complications (EDIC) study, a subset of the 1441 subjects originally enrolled in the multicenter Diabetes Control and Complications Trial.
  
  
  METHODS
  At each annual visit, subjects were asked by EDIC staff whether they had undergone PRP, FP, or both since the last completed annual clinic visit. Fundus photographs were collected from one quarter of the cohort each year and from the entire cohort at EDIC years 4 and 10. Photographs were graded for the presence and extent of PRP and FP. Seventeen years of subject reporting and photograph grading of PRP and FP were compared in EDIC subjects.
  
  
  METHODS
  The κ, sensitivity, specificity, and positive and negative predictive values were calculated for subject-reported PRP and FP. Factors influencing subject misreporting were investigated.
  
  
  RESULTS
  For subject reporting, 1244 (96%) of 1296 subjects with gradable photographs accurately reported whether they had a history of PRP in one or both eyes, and 1259 (97.5%) of 1291 with valid photographs correctly reported their history of FP. For PRP and FP, sensitivities were 90.4% and 74.0%, respectively; specificities were 96.0% and 98.8%, respectively; positive predictive values were 75.9% and 80.3%, respectively; negative predictive values were 98.9% and 98.4%, respectively; and κ values were 0.80 and 0.76, respectively. Risk factors associated with misreporting included prior laser for diabetic retinopathy and prior ocular surgery (each P<0.04).
  
  
  CONCLUSIONS
  For subjects with type 1 diabetes, in the absence of a clinical examination or fundus photographs, subject self-report could be a reliable tool in a well-monitored study for assessing laser treatment type in diabetic retinopathy.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grassi
authors.affiliation: The Biostatistics Center, George Washington University, Rockville, Maryland.
authors.forename: Wanjie
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, Wisconsin.
authors.forename: Sapna
authors.initials: S
authors.lastname: Gangaputra
authors.affiliation: The Biostatistics Center, George Washington University, Rockville, Maryland.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Cleary
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, Wisconsin.
authors.forename: Larry
authors.initials: L
authors.lastname: Hubbard
authors.affiliation: The Biostatistics Center, George Washington University, Rockville, Maryland.
authors.forename: John M
authors.initials: JM
authors.lastname: Lachin
authors.affiliation: The Biostatistics Center, George Washington University, Rockville, Maryland.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Ophthalmology, Weill Cornell Medical College, New York, New York.
authors.forename: Szilárd
authors.initials: S
authors.lastname: Kiss
authors.affiliation: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Barkmeier
authors.affiliation: Department of Ophthalmology, University of Missouri, Columbia, Missouri.
authors.forename: Arghavan
authors.initials: A
authors.lastname: Almony
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, Wisconsin.
authors.forename: Matthew
authors.initials: M
authors.lastname: Davis
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, Wisconsin.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.affiliation: Department of Ophthalmology & Visual Sciences, University of Wisconsin, Madison, Wisconsin.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Danis
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D010781:Photography; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report / Q000592:standards*; D012680:Sensitivity and Specificity
references.citation: N Engl J Med. 1993 Sep 30;329(14):977-86
references.pmid: 8366922
references.citation: Arch Ophthalmol. 1985 Dec;103(12):1796-806
references.pmid: 2866759
references.citation: J Am Soc Nephrol. 1998 Jan;9(1):85-9
references.pmid: 9440091
references.citation: Ophthalmology. 2012 Nov;119(11):2312-8
references.pmid: 22999634
references.citation: Hum Mol Genet. 2011 Jun 15;20(12):2472-81
references.pmid: 21441570
references.citation: Ophthalmology. 2011 Apr;118(4):609-14
references.pmid: 21459214
references.citation: Arch Ophthalmol. 1995 Jan;113(1):36-51
references.pmid: 7826293
references.citation: Drugs. 2012 Mar 5;72(4):509-23
references.pmid: 22356289
references.citation: Ophthalmology. 1978 Jan;85(1):82-106
references.pmid: 345173
references.citation: Am J Ophthalmol. 2009 Mar;147(3):501-4
references.pmid: 19054495
references.citation: Arch Ophthalmol. 2004 Apr;122(4):552-63
references.pmid: 15078674
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: Diabetes Care. 1999 Jan;22(1):99-111
references.pmid: 10333910
references.citation: Lancet. 1985 Jan 5;1(8419):53-4
references.pmid: 2856982
references.citation: Ophthalmology. 2012 Sep;119(9):1725-30
references.pmid: 22537615
references.citation: Ophthalmology. 2010 Jun;117(6):1064-1077.e35
references.pmid: 20427088
references.citation: Ophthalmology. 1981 Jul;88(7):583-600
references.pmid: 7196564