Genome Institute of Singapore, 60 Biopolis Street, Genome, #02-01, Singapore, 138672, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
Sci Rep. 2019 Mar 5;9(1):3527. doi: 10.1038/s41598-019-40072-0.
Breast cancer patients commonly present with comorbidities which are known to influence treatment decisions and survival. We aim to examine agreement between self-reported and register-based medical records (National Patient Register [NPR]). Ascertainment of nine conditions, using individually-linked data from 64,961 women enrolled in the Swedish KARolinska MAmmography Project for Risk Prediction of Breast Cancer (KARMA) study. Agreement was assessed using observed proportion of agreement (overall agreement), expected proportion of agreement, and Cohen's Kappa statistic. Two-stage logistic regression models taking into account chance agreement were used to identify potential predictors of overall agreement. High levels of overall agreement (i.e. ≥86.6%) were observed for all conditions. Substantial agreement (Cohen's Kappa) was observed for myocardial infarction (0.74), diabetes (0.71) and stroke (0.64) between self-reported and NPR data. Moderate agreement was observed for preeclampsia (0.51) and hypertension (0.46). Fair agreement was observed for heart failure (0.40) and polycystic ovaries or ovarian cysts (0.27). For hyperlipidemia (0.14) and angina (0.10), slight agreement was observed. In most subgroups we observed negative specific agreement of >90%. There is no clear reference data source for ascertainment of conditions. Negative specific agreement between NPR and self-reported data is consistently high across all conditions.
乳腺癌患者常伴有合并症，这些合并症已知会影响治疗决策和生存。我们旨在检查自我报告和基于登记的医疗记录（国家患者登记处[ NPR ]）之间的一致性。使用从瑞典 KARolinska 乳腺癌风险预测的乳房摄影项目（KARMA）研究中登记的 64961 名女性的个体链接数据，确定了九种情况。使用观察到的一致性比例（总体一致性）、预期一致性比例和 Cohen 的 Kappa 统计量来评估一致性。考虑到偶然一致性的两阶段逻辑回归模型用于确定总体一致性的潜在预测因素。对于所有条件，均观察到总体一致性（即≥86.6%）水平较高。在自我报告和 NPR 数据之间，观察到心肌梗死（0.74）、糖尿病（0.71）和中风（0.64）具有实质性一致性（Cohen 的 Kappa）。观察到子痫前期（0.51）和高血压（0.46）具有中度一致性。观察到心力衰竭（0.40）和多囊卵巢或卵巢囊肿（0.27）具有适度一致性。对于高脂血症（0.14）和心绞痛（0.10），观察到轻度一致性。在大多数亚组中，我们观察到特异性一致率均>90%。对于确定条件，没有明确的参考数据源。 NPR 和自我报告数据之间的特异性负一致率在所有条件下均较高。
