Differences in morbidity measures and risk factor identification using multiple data sources: the case of coronary heart disease.

The NHANES I Epidemiologic Followup Study contains several sources of information that can be used to define case status. Incidence rates and relative risks associated with selected, documented risk factors for heart disease were estimated using nine different case definitions. Despite wide variation in the estimates of incidence, the characteristics of the cases were remarkably similar as were the risks associated with heart disease incidence. The main difference occurred when cases were defined on the basis of death certificate information. Cases defined this way are more severe and models based on this definition result in relative risks of greater magnitude.