Darvishian Maryam, Chu Jessica, Simkin Jonathan, Woods Ryan, Bhatti Parveen
Prevention, Screening, and Hereditary Cancer Program, BC Cancer, Vancouver, BC, Canada.
Cancer Control Research, BC Cancer Research Institute, Vancouver, BC, Canada.
Front Epidemiol. 2022 Dec 21;2:1054485. doi: 10.3389/fepid.2022.1054485. eCollection 2022.
Population-based studies of non-cancer chronic disease often rely on self-reported data for disease diagnosis, which may be incomplete, unreliable and suffer from bias. Recently, the British Columbia Generations Project (BCGP; = 29,736) linked self-reported chronic disease history data to a Chronic Disease Registry (CDR) that applied algorithms to administrative health data to ascertain diagnoses of multiple chronic diseases in the Province of British Columbia. For the 10 diseases captured by both self-report and the CDR, including asthma, chronic obstructive pulmonary disease (COPD), diabetes, hypertension, multiple sclerosis, myocardial infarction, osteoarthritis, osteoporosis, rheumatoid arthritis, and stroke, we calculated Cohen's kappa coefficient to examine concordance of chronic disease status (i.e., ever/never diagnosed) between the data sources. Using CDR data as the gold standard, we also calculated sensitivity, specificity, and positive-predictive value (PPV) for self-reported chronic disease occurrence. The prevalence of each chronic disease was similar across both data sources. Substantial levels of concordance (0.66-0.73) and moderate to high sensitivities (0.64-0.92), specificities (0.98-0.99) and PPVs (0.55-0.84) were observed for diabetes, hypertension, multiple sclerosis, and myocardial infarction. We did observe degree of concordance to vary by age, sex, body mass index (BMI), health perception, and ethnicity across most of the chronic diseases that were evaluated. While administrative health data are imperfect, they are less likely to suffer from bias, making them a reasonable gold standard. Our results demonstrate that for at least some chronic diseases, self-report may be a reasonable method for case ascertainment. However, characteristics of the study population will likely have impacts on the quality of the data.
基于人群的非癌症慢性病研究通常依赖自我报告数据进行疾病诊断,而这些数据可能不完整、不可靠且存在偏差。最近,不列颠哥伦比亚世代项目(BCGP;n = 29,736)将自我报告的慢性病病史数据与慢性病登记处(CDR)相链接,该登记处运用算法处理行政健康数据,以确定不列颠哥伦比亚省多种慢性病的诊断情况。对于自我报告和CDR均涵盖的10种疾病,包括哮喘、慢性阻塞性肺疾病(COPD)、糖尿病、高血压、多发性硬化症、心肌梗死、骨关节炎、骨质疏松症、类风湿性关节炎和中风,我们计算了科恩kappa系数,以检验数据源之间慢性病状态(即曾被诊断/未被诊断)的一致性。以CDR数据作为金标准,我们还计算了自我报告慢性病发生情况的敏感性、特异性和阳性预测值(PPV)。两种数据源中每种慢性病的患病率相似。对于糖尿病、高血压、多发性硬化症和心肌梗死,观察到了较高水平的一致性(0.66 - 0.73)以及中等到较高的敏感性(0.64 - 0.92)、特异性(0.98 - 0.99)和PPV(0.55 - 0.84)。我们确实观察到,在大多数被评估的慢性病中,一致性程度因年龄、性别、体重指数(BMI)、健康认知和种族而有所不同。虽然行政健康数据并不完美,但它们不太可能存在偏差,使其成为合理的金标准。我们的结果表明,对于至少一些慢性病,自我报告可能是一种合理的病例确定方法。然而,研究人群的特征可能会对数据质量产生影响。