Berete Finaba, Heyden Johan Van der, Demarest Stefaan, Charafeddine Rana, Tafforeau Jean, Oyen Herman Van, Bruyère Olivier, Renard Françoise
Department Epidemiology and Public Health , Sciensano, Brussels, Belgium.
Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.
Eur J Public Health. 2021 Feb 1;31(1):214-220. doi: 10.1093/eurpub/ckaa217.
The validity of self-reported mammography uptake is often questioned. We assessed the related selection and reporting biases among women aged 50-69 years in the Belgian Health Interview Survey (BHIS) using reimbursement data for mammography stemming from the Belgian Compulsory Health Insurance organizations (BCHI).
Individual BHIS 2013 data (n = 1040) were linked to BCHI data 2010-13 (BHIS-BCHI sample). Being reimbursed for mammography within the last 2-years was used as the gold standard. Selection bias was assessed by comparing BHIS estimates reimbursement rates in BHIS-BCHI with similar estimates from the Echantillon Permanent/Permanente Steekproef (EPS), a random sample of BCHI data, while reporting bias was investigated by comparing self-reported versus reimbursement information in the BHIS-BCHI. Reporting bias was further explored through measures of agreement and logistic regression.
Mammography uptake rates based on self-reported information and reimbursement from the BHIS-BCHI were 75.5% and 69.8%, respectively. In the EPS, it was 64.1%. The validity is significantly affected by both selection bias {relative size = 8.93% [95% confidence interval (CI): 3.21-14.64]} and reporting bias [relative size = 8.22% (95% CI: 0.76-15.68)]. Sensitivity was excellent (93.7%), while the specificity was fair (66.4%). The agreement was moderate (kappa = 0.63). Women born in non-EU countries (OR = 2.81, 95% CI: 1.54-5.13), with high household income (OR = 1.27, 95% CI: 1.02-1.60) and those reporting poor perceived health (OR = 1.41, 95% CI: 1.14-1.73) were more likely to inaccurately report their mammography uptake.
The validity of self-reported mammography uptake in women aged 50-69 years is affected by both selection and reporting bias. Both administrative and survey data are complementary when assessing mammography uptake.
自我报告的乳房X光检查接受率的有效性常常受到质疑。我们利用比利时强制健康保险机构（BCHI）提供的乳房X光检查报销数据，在比利时健康访谈调查（BHIS）中评估了50至69岁女性中的相关选择偏倚和报告偏倚。
将2013年BHIS的个体数据（n = 1040）与2010 - 13年的BCHI数据相链接（BHIS - BCHI样本）。过去两年内有乳房X光检查报销记录被用作金标准。通过比较BHIS - BCHI中BHIS估计的报销率与来自Echantillon Permanent/Permanente Steekproef（EPS，BCHI数据的随机样本）的类似估计值来评估选择偏倚，同时通过比较BHIS - BCHI中自我报告信息与报销信息来调查报告偏倚。通过一致性测量和逻辑回归进一步探讨报告偏倚。
基于BHIS - BCHI中自我报告信息和报销记录的乳房X光检查接受率分别为75.5%和69.8%。在EPS中，该接受率为64.1%。有效性受到选择偏倚{相对大小 = 8.93% [95%置信区间（CI）：3.21 - 14.64]}和报告偏倚[相对大小 = 8.22%（95% CI：0.76 - 15.68）]的显著影响。敏感性极佳（93.7%），而特异性一般（66.4%）。一致性为中等（kappa = 0.63）。出生在非欧盟国家的女性（比值比 = 2.81，95% CI：1.54 - 5.13）、家庭收入高的女性（比值比 = 1.27，95% CI：1.02 - 1.60）以及自我感觉健康状况差的女性（比值比 = 1.41，95% CI：1.14 - 1.73）更有可能不准确地报告她们的乳房X光检查接受情况。
50至69岁女性自我报告的乳房X光检查接受率的有效性受到选择偏倚和报告偏倚的影响。在评估乳房X光检查接受率时，行政数据和调查数据具有互补性。
