Jain M G, Rohan T E, Howe G R
Department of Public Health Sciences, University of Toronto, Ontario, Canada.
Epidemiology. 1999 May;10(3):260-3.
There have been relatively few epidemiological studies to verify the information obtained from study participants on the use of menopausal hormone replacement therapy. We conducted this study as part of a case-control study of diet, hormone use, and endometrial cancer in Toronto, Ontario, Canada, 1994-1998. We compared records from 653 subjects, 30-79 years of age, with reports from their physicians on ever/never use of hormone replacement therapy and duration, type, and dose of hormone replacement therapy. A total of 88% of the interview records were in agreement with physician reports for ever/never use of hormone replacement therapy. The overall kappa value for ever/never use agreement was 0.76 (range = 0.71-0.81), and the intraclass correlation coefficient was 0.64 (range = 0.57-0.70) for duration of hormone replacement therapy use, indicating good agreement; similar correlations were seen among cases and controls for overall use, as well as estrogen- or progestogen-alone use. Concordance for brand codes was observed for about 43% of the subjects. This study suggests that information obtained by interview in case-control studies provides a reasonable measure of ever use of hormone replacement therapy and duration of use. Interviews, however, do not represent a reliable source of information on brands and dosage of hormone replacement therapy preparations.
相对而言,用以核实从研究参与者处获取的关于绝经激素替代疗法使用情况信息的流行病学研究较少。我们开展此项研究,作为1994年至1998年在加拿大安大略省多伦多市进行的一项关于饮食、激素使用与子宫内膜癌的病例对照研究的一部分。我们将653名年龄在30至79岁之间的受试者的记录,与他们的医生关于是否曾使用激素替代疗法以及激素替代疗法的持续时间、类型和剂量的报告进行了比较。在是否曾使用激素替代疗法方面,共有88%的访谈记录与医生报告一致。在是否曾使用激素替代疗法的一致性方面,总体kappa值为0.76(范围 = 0.71 - 0.81),在激素替代疗法使用持续时间方面,组内相关系数为0.64(范围 = 0.57 - 0.70),表明一致性良好;在总体使用以及单独使用雌激素或孕激素方面,病例组和对照组之间也观察到了类似的相关性。约43%的受试者观察到品牌代码的一致性。本研究表明,在病例对照研究中通过访谈获得的信息为激素替代疗法的既往使用情况和使用持续时间提供了合理的衡量标准。然而,访谈并非激素替代疗法制剂品牌和剂量信息的可靠来源。