Vernon Sally W, Tiro Jasmin A, Vojvodic Rachel W, Coan Sharon, Diamond Pamela M, Greisinger Anthony, Fernandez Maria E
University of Texas-Houston School of Public Health, Division of Health Promotion and Behavioral Sciences, Houston, TX 77030, USA.
Cancer Epidemiol Biomarkers Prev. 2008 Apr;17(4):758-67. doi: 10.1158/1055-9965.EPI-07-2855. Epub 2008 Apr 1.
Valid and reliable self-report measures of cancer screening behaviors are important for evaluating efforts to improve adherence to guidelines. We evaluated test-retest reliability and validity of self-report of the fecal occult blood test (FOBT), sigmoidoscopy (SIG), colonoscopy (COL), and barium enema (BE) using the National Cancer Institute colorectal cancer screening (CRCS) questionnaire. A secondary objective was to evaluate reliability and validity by mail, telephone, and face-to-face survey administration modes. Consenting men and women, 51 to 74 years old, receiving care at a multispecialty clinic for at least 5 years who had not been diagnosed with colorectal cancer were stratified by prior CRCS status and randomized to survey mode (n = 857). Within survey mode, respondents were randomized to complete a second survey at 2 weeks, 3 months, or 6 months. Comparing self-report with administrative and medical records, concordance estimates were 0.91 for COL, 0.85 for FOBT, 0.85 for SIG, and 0.92 for BE. Overall sensitivity estimates were 0.91 for COL, 0.82 for FOBT, 0.76 for SIG, and 0.56 for BE. Specificity estimates were 0.91 for COL, 0.86 for FOBT, 0.89 for SIG, and 0.97 for BE. Sensitivity and specificity varied little by survey mode for any test. Report-to-records ratio showed overreporting for SIG (1.1), COL (1.15), and FOBT (1.57), and underreporting for BE (0.82). Reliability at all time intervals was highest for COL; there was no consistent pattern according to survey mode. This study provides evidence to support the use of the National Cancer Institute CRCS questionnaire to assess self-report with any of the three survey modes.
有效的、可靠的癌症筛查行为自我报告测量方法对于评估提高指南依从性的努力非常重要。我们使用美国国立癌症研究所的结直肠癌筛查(CRCS)问卷,评估了粪便潜血试验(FOBT)、乙状结肠镜检查(SIG)、结肠镜检查(COL)和钡灌肠(BE)自我报告的重测信度和效度。第二个目标是通过邮件、电话和面对面调查管理模式评估信度和效度。年龄在51至74岁之间、在多专科诊所接受治疗至少5年且未被诊断为结直肠癌的同意参与的男性和女性,根据先前的CRCS状态进行分层,并随机分配到调查模式(n = 857)。在调查模式内,受访者被随机分配在2周、3个月或6个月时完成第二次调查。将自我报告与行政和医疗记录进行比较,COL的一致性估计为0.91,FOBT为0.85,SIG为0.85,BE为0.92。总体敏感性估计COL为0.91,FOBT为0.82,SIG为0.76,BE为0.56。特异性估计COL为0.91,FOBT为0.86,SIG为0.89,BE为0.97。对于任何检测,敏感性和特异性在调查模式之间变化不大。报告与记录比率显示SIG(1.1)、COL(1.15)和FOBT(1.57)存在报告过度情况,BE(0.82)存在报告不足情况。COL在所有时间间隔的信度最高;根据调查模式没有一致的模式。本研究提供了证据支持使用美国国立癌症研究所的CRCS问卷通过三种调查模式中的任何一种来评估自我报告。