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自我报告信息与药房报销记录在降脂药物暴露方面具有可比性。

Self-reported information and pharmacy claims were comparable for lipid-lowering medication exposure.

作者信息

Brown David W, Anda Robert F, Felitti Vincent J

机构信息

Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.

出版信息

J Clin Epidemiol. 2007 May;60(5):525-9. doi: 10.1016/j.jclinepi.2006.08.007. Epub 2006 Dec 11.

Abstract

OBJECTIVE

To examine agreement between self-reported exposure to lipid-lowering medications and objective evidence of filling prescribed lipid-lowering medications.

STUDY DESIGN AND SETTING

Using data from 7,918 adults from the Adverse Childhood Experiences (ACE) Study, we calculated the sensitivity, specificity, and positive (PV+) and negative (PV-) predictive values, and likelihood ratios for self-reported exposure to lipid-lowering medications compared to exposure obtained from pharmacy claims (gold standard) both overall and by age, sex, race/ethnicity, education, and ACE Score.

RESULTS

Eight percent (n=655) of adults self-reported lipid-lowering medication exposure, and 379 adults filled at least one lipid-lowering prescription within 60 days of the baseline exam during 1997. The sensitivity of self-reported exposure was nearly 94%; the specificity was 96%; the PV+ was 54%; and the PV- was nearly 100%. Values for sensitivity, specificity, PV+, and PV- were similar across participant characteristics.

CONCLUSION

A self-reported measure of lipid-lowering medication exposure was accurate with high sensitivity and specificity while the PV+ of self-reported lipid-lowering medication exposure was relatively low. These findings suggest that self-reported exposure to lipid-lowering medications may be useful in surveys that examine the prevalence of hyperlipidemia, but may overestimate actual exposure in studies monitoring trends in use of lipid-lowering medications.

摘要

目的

检验自我报告的降脂药物暴露情况与填写的降脂处方药客观证据之间的一致性。

研究设计与背景

利用来自不良童年经历(ACE)研究的7918名成年人的数据,我们计算了自我报告的降脂药物暴露情况与通过药房报销记录(金标准)获得的暴露情况相比的敏感性、特异性、阳性(PV +)和阴性(PV -)预测值以及似然比,总体上以及按年龄、性别、种族/民族、教育程度和ACE评分进行了计算。

结果

8%(n = 655)的成年人自我报告有降脂药物暴露,379名成年人在1997年基线检查后的60天内至少填写了一张降脂处方药。自我报告暴露的敏感性接近94%;特异性为96%;PV +为54%;PV -接近100%。敏感性、特异性、PV +和PV -的值在各参与者特征中相似。

结论

自我报告的降脂药物暴露测量具有较高的敏感性和特异性,较为准确,但自我报告的降脂药物暴露的PV +相对较低。这些发现表明,自我报告的降脂药物暴露在调查高脂血症患病率时可能有用,但在监测降脂药物使用趋势的研究中可能高估实际暴露情况。

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