Yamagishi Kazumasa, Ikeda Ai, Iso Hiroyasu, Inoue Manami, Tsugane Shoichiro
Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, and Institute of Community Medicine, University of Tsukuba, Tsukuba, Japan.
J Clin Epidemiol. 2009 Jun;62(6):667-73. doi: 10.1016/j.jclinepi.2008.07.016. Epub 2008 Dec 23.
We sought to clarify the validity of self-reported stroke and myocardial infarction (MI) among Japanese population, because information on the validity, particularly on the sensitivity, of self-reported cardiovascular disease is limited and may differ among countries.
Using the 10-year follow-up questionnaire and a stroke and MI registry in the Japan Public Health Center-based prospective Study (JPHC Study) cohort (n=91,186), we calculated sensitivity and positive predictive values of self-reported stroke and MI incidence over 10 years.
Sensitivity of self-reported incident stroke was 73%, and that for MI was 82%. Positive predictive values were 57% for stroke and 43% for MI. The supplemental inclusion of self-reported angina pectoris increased the sensitivity of MI to 89%, but attenuated the positive predictive value to 18%. Sensitivity of self-reported stroke was highest for subarachnoid hemorrhage (88%), but did not differ greatly among other stroke subtypes, affected sites or size.
Self-reported stroke and MI seem sensitive enough to use for exclusion of stroke and MI at baseline in Japanese cohort studies. However, self-report has too many false positives to be used as the only criterion for incident stroke and MI.
我们试图阐明日本人群中自我报告的中风和心肌梗死(MI)的有效性,因为关于自我报告的心血管疾病有效性的信息,尤其是敏感性方面的信息有限,且可能因国家而异。
利用日本公共卫生中心前瞻性研究(JPHC研究)队列(n = 91,186)中的10年随访问卷以及中风和心肌梗死登记册,我们计算了10年间自我报告的中风和心肌梗死发病率的敏感性和阳性预测值。
自我报告的中风发病率敏感性为73%,心肌梗死为82%。中风的阳性预测值为57%,心肌梗死为43%。补充纳入自我报告的心绞痛后,心肌梗死的敏感性提高到89%,但阳性预测值降至18%。自我报告的中风在蛛网膜下腔出血方面敏感性最高(88%),但在其他中风亚型、受累部位或大小方面差异不大。
在日本队列研究中,自我报告的中风和心肌梗死似乎足够敏感,可用于在基线时排除中风和心肌梗死。然而,自我报告有太多假阳性,不能作为新发中风和心肌梗死的唯一标准。