Ling S M, Fried L P, Garrett E, Hirsch R, Guralnik J M, Hochberg M C
Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Rheumatol. 2000 Jun;27(6):1390-4.
To determine the accuracy of self-report of physician diagnosed rheumatoid arthritis (RA) in moderately to severely disabled older women.
A total of 1002 participants in the Women's Health and Aging Study were included. These women were > or =65 years old, had an average of 4 chronic illnesses, and represented the one-third most disabled women living in the community. Self-report of a physician's diagnosis of RA was compared to cases of "definite" RA that were adjudicated using an algorithm modeled on the American College of Rheumatology criteria for RA.
The sensitivity of self-report of physician diagnosed RA was 77%, with 90.6% specificity and 99% negative predictive value, kappa = 0.46. The positive predictive value was 34% and likely reflected the low prevalence of RA in this sample (3.1%). Five of the 6 women who did not correctly report RA were under the care of a rheumatologist.
The accuracy of self-report of a physician's diagnosis of RA in this sample of disabled women with multiple chronic illnesses matched that observed in the general adult population of previous studies. Accuracy was enhanced by including report of receiving care by a rheumatologist.
确定中度至重度残疾老年女性中医生诊断的类风湿性关节炎（RA）自我报告的准确性。
纳入了1002名女性健康与衰老研究的参与者。这些女性年龄≥65岁，平均患有4种慢性病，代表了社区中残疾程度最高的三分之一女性。将医生诊断为RA的自我报告与使用基于美国风湿病学会RA标准的算法判定的“确诊”RA病例进行比较。
医生诊断为RA的自我报告的敏感性为77%，特异性为90.6%，阴性预测值为99%，kappa值为0.46。阳性预测值为34%，可能反映了该样本中RA的低患病率（3.1%）。6名未正确报告RA的女性中有5名正在接受风湿病专家的治疗。
在这个患有多种慢性病的残疾女性样本中，医生诊断为RA的自我报告准确性与先前研究中一般成年人群的观察结果相当。通过纳入接受风湿病专家治疗的报告，准确性得到了提高。
