荷兰一项基于人群的研究中的心血管疾病及风险因素：问卷信息与病历之间的一致性

Cardiovascular diseases and risk factors in a population-based study in The Netherlands: agreement between questionnaire information and medical records.

作者信息

Klungel O H, de Boer A, Paes A H, Seidell J C, Bakker A

机构信息

Department of Pharmacoepidemiology and Pharmacotherapy, Faculty of Pharmacy, University of Utrecht, The Netherlands.

出版信息

Neth J Med. 1999 Oct;55(4):177-83. doi: 10.1016/s0300-2977(99)00045-5.

DOI:10.1016/s0300-2977(99)00045-5

PMID:10555434

Abstract

BACKGROUND

Since 1987 the Monitoring Project on Cardiovascular Risk Factors has been carried out in The Netherlands. The purpose of the present study was to assess the agreement between the self-reported questionnaire information that was collected in this survey on cardiovascular diseases and risk factors and information from medical records.

METHODS

From 1987 to 1991, over 36,000 men and women aged 20-59 years have participated in the Monitoring Project on Cardiovascular Disease Risk Factors, a cross-sectional population-based study. We compared self-reported information on cardiovascular diseases and risk factors with the general practitioners medical records from a sample of 899 hypertensive subjects.

RESULTS

The highest proportion of positive self-reports could be confirmed by the medical records for diabetes conditional on self-report of medication use for this condition (100%), and a history of hypertension conditional on the presence of blood pressure recordings in the medical records (91%). The lowest percentage of positive self-reports confirmed by medical records was a family history of myocardial infarction (3-5%). More than 80% of the negative self-reports were confirmed by the medical records for most conditions, except for history of hypertension, conditional on the presence of blood pressure recordings in the medical records (40%). The overall agreement above chance was substantial for cerebrovascular disease (kappa = 0.78) and diabetes (kappa = 0.75), moderate for myocardial infarction (kappa = 0.55), poor for myocardial infarction of the respondents' father (kappa = 0.07) and mother (kappa = 0.05), and fair to moderate for all other self-reported conditions.

CONCLUSION

Agreement between self-reported information and medical records was variable. For further studies, self-reports of cardiovascular diseases and risk factors should preferably be complemented with information from other sources such as medical records.

摘要

背景

自1987年以来，荷兰开展了心血管危险因素监测项目。本研究的目的是评估本次调查中收集的关于心血管疾病和危险因素的自我报告问卷信息与病历信息之间的一致性。

方法

1987年至1991年，超过36000名年龄在20 - 59岁之间的男性和女性参与了心血管疾病危险因素监测项目，这是一项基于人群的横断面研究。我们将899名高血压患者样本的心血管疾病和危险因素的自我报告信息与全科医生的病历进行了比较。

结果

对于糖尿病，以自我报告使用该疾病药物为条件，自我报告阳性的最高比例可通过病历得到证实（100%）；对于高血压病史，以病历中有血压记录为条件，自我报告阳性的最高比例可通过病历得到证实（91%）。病历证实的自我报告阳性最低比例是心肌梗死家族史（3 - 5%）。对于大多数情况，超过80%的自我报告阴性可通过病历得到证实，但高血压病史除外，以病历中有血压记录为条件（40%）。对于脑血管疾病（kappa = 0.78）和糖尿病（kappa = 0.75），总体一致性高于偶然水平，为实质性；对于心肌梗死（kappa = 0.55），为中等；对于受访者父亲（kappa = 0.07）和母亲（kappa = 0.05）的心肌梗死，为差；对于所有其他自我报告的情况，为中等至良好。