title: Identification of diabetes, heart disease, hypertension and stroke in mid- and older-aged women: Comparing self-report and administrative hospital data records.
abstract: OBJECTIVE
  To estimate the prevalence of diabetes, heart disease, hypertension and stroke in self-report and hospital data in two cohorts of women; measure sensitivity and agreement between data sources; and compare between cohorts.
  
  
  METHODS
  Women born between 1946-1951 and 1921-1926 who participated in the Australian Longitudinal Study on Women's Health (ALSWH); were New South Wales residents; and admitted to hospital (2004-2008) were included in the present study. The prevalence of diabetes, heart disease, hypertension and stroke was estimated using self-report (case 1 at latest survey, case 2 across multiple surveys) and hospital records. Agreement (kappa) and sensitivity (%) were calculated. Logistic regression measured the association between patient characteristics and agreement.
  
  
  RESULTS
  Hypertension had the highest prevalence and estimates were higher for older women: 32.5% case 1, 45.4% case 2, 12.8% in hospital data (1946-1951 cohort); 57.8% case 1, 73.2% case 2, 38.2% in hospital data (1921-1926 cohort). Agreement was substantial for diabetes: κ = 0.75 case 1, κ = 0.70 case 2 (1946-1951 cohort); κ = 0.77 case 1, κ = 0.80 case 2 (1921-1926 cohort), and lower for other conditions. The 1946-1951 cohort had 2.08 times the odds of agreement for hypertension (95% CI 1.56 to 2.78; P < 0.0001), and 6.25 times the odds of agreement for heart disease (95% CI 4.35 to 10.0; P < 0.0001), compared with the 1921-1926 cohort.
  
  
  CONCLUSIONS
  Substantial agreement was found for diabetes, indicating accuracy of ascertainment using self-report or hospital data. Self-report data appears to be less accurate for heart disease and stroke. Hypertension was underestimated in hospital data. These findings have implications for epidemiological studies relying on self-report or administrative data.
authors.affiliation: Population Health Division, Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, New South Wales, Australia.
authors.forename: Tina J
authors.initials: TJ
authors.lastname: Navin Cristina
authors.affiliation: Research Centre for Gender, Health and Ageing, University of Newcastle, Callaghan, New South Wales, Australia.|Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Stewart Williams
authors.affiliation: Central Queensland University, Rockhampton, Queensland, Australia.
authors.forename: Lynne
authors.initials: L
authors.lastname: Parkinson
authors.affiliation: Faculty of Health, University of Technology, Sydney, New South Wales, Australia.
authors.forename: David W
authors.initials: DW
authors.lastname: Sibbritt
authors.affiliation: Research Centre for Gender, Health and Ageing, University of Newcastle, Callaghan, New South Wales, Australia.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Byles
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001315:Australia / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D015995:Prevalence; D057566:Self Report; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology*; D055815:Young Adult
keywords: chronic disease; heart disease; medical records; self-report; stroke