Nash Sarah H, Day Gretchen, Hiratsuka Vanessa Y, Zimpelman Garrett L, Koller Kathryn R
a Alaska Native Tumor Registry, Alaska Native Epidemiology Center, Community Health Services , Alaska Native Tribal Health Consortium , Anchorage , AK , USA.
b Clinical and Research Services, Community Health Services , Alaska Native Tribal Health Consortium , Anchorage , AK , USA.
Int J Circumpolar Health. 2019 Dec;78(1):1571383. doi: 10.1080/22423982.2019.1571383.
Reliance on self-reported health status information as a measure of population health can be challenging due to errors associated with participant recall. We sought to determine agreement between self-reported and registry-recorded site-specific cancer diagnoses in a cohort of Alaska Native people. We linked cancer history information from the Alaska Education and Research Towards Health (EARTH) cohort and the Alaska Native Tumor Registry (ANTR), and calculated validity measures (sensitivity, specificity, positive predictive value, negative predictive value, kappa). Multiple logistic regression models were used to assess independent associations of demographic variables with incorrect reporting. We found that among Alaska EARTH participants, 140 self-reported a history of cancer, and 99 matched the ANTR. Sensitivity ranged from 79% (colorectal cancer) to 100% (prostate cancer); specificity was over 98% for all-sites examined. Kappa was higher among prostate and female breast cancers (κ=0.86) than colorectal cancers (κ=0.63). Women (odds ratio [OR] (95% confidence interval [CI]): 2.8 (1.49-5.31)) and participants who were older than 50 years (OR (95% CI): 2.8 (1.53-4.12)) were more likely to report incorrectly. These data showed good agreement between self-reported and registry-recorded cancer history. This may be attributed to the high quality of care within the Alaska Tribal Health System, which strongly values patient-provider relationships and the provision of culturally appropriate care.
由于与参与者回忆相关的误差，依靠自我报告的健康状况信息作为衡量人群健康的指标可能具有挑战性。我们试图确定阿拉斯加原住民队列中自我报告的和登记记录的特定部位癌症诊断之间的一致性。我们将阿拉斯加健康促进教育与研究（EARTH）队列和阿拉斯加原住民肿瘤登记处（ANTR）的癌症病史信息进行了关联，并计算了有效性指标（敏感性、特异性、阳性预测值、阴性预测值、kappa值）。使用多个逻辑回归模型来评估人口统计学变量与错误报告之间的独立关联。我们发现，在阿拉斯加EARTH队列参与者中，有140人自我报告有癌症病史，其中99人与ANTR记录相符。敏感性范围从79%（结直肠癌）到100%（前列腺癌）；所有检查部位的特异性均超过98%。前列腺癌和女性乳腺癌的kappa值（κ=0.86）高于结直肠癌（κ=0.63）。女性（优势比[OR]（95%置信区间[CI]）：2.8（1.49 - 5.31））和年龄超过50岁的参与者（OR（95%CI）：2.8（1.53 - 4.12））更有可能报告错误。这些数据表明自我报告的和登记记录的癌症病史之间具有良好的一致性。这可能归因于阿拉斯加部落卫生系统内高质量的医疗服务，该系统非常重视医患关系以及提供符合文化背景的医疗服务。
