Moderate agreement between self-reported stroke and hospital-recorded stroke in two cohorts of Australian women: a validation study

Jackson, Caroline A., Mishra, Gita D., Tooth, Leigh, Byles, Julie and Dobson, Annette (2015) Moderate agreement between self-reported stroke and hospital-recorded stroke in two cohorts of Australian women: a validation study. BMC Research Methodology, 15 7.1-7.10. doi:10.1186/1471-2288-15-7

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Author Jackson, Caroline A.
Mishra, Gita D.
Tooth, Leigh
Byles, Julie
Dobson, Annette
Title Moderate agreement between self-reported stroke and hospital-recorded stroke in two cohorts of Australian women: a validation study
Journal name BMC Research Methodology   Check publisher's open access policy
ISSN 1471-2288
Publication date 2015-01-23
Sub-type Article (original research)
DOI 10.1186/1471-2288-15-7
Open Access Status DOI
Volume 15
Start page 7.1
End page 7.10
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2016
Language eng
Formatted abstract
Background: Conflicting findings on the validity of self-reported stroke from existing studies creates uncertainty about the appropriateness of using self-reported stroke in epidemiological research. We aimed to compare self-reported stroke against hospital-recorded stroke, and investigate reasons for disagreement.

Methods: We included participants from the Australian Longitudinal Study on Women’s Health born in 1921–26 (n = 1556) and 1946–51 (n = 2119), who were living in New South Wales and who returned all survey questionnaires over a defined period of time. We determined agreement between self-reported and hospitalised stroke by calculating sensitivity, specificity and kappa statistics. We investigated whether characteristics including age, education, area of residence, country of birth, language spoken at home, recent mental health at survey completion and proxy completion of questionnaire were associated with disagreement, using logistic regression analysis to obtain odds ratios (ORs) with 95% confidence intervals (CIs).

Results: Agreement between self-report and hospital-recorded stroke was fair in older women (kappa 0.35, 95% CI 0.25 to 0.46) and moderate in mid-aged women (0.56, 95% CI 0.37 to 0.75). There was a high proportion with unverified self-reported stroke, partly due to: reporting of transient ischaemic attacks; strokes occurring outside the period of interest; and possible reporting of stroke-like conditions. In the older cohort, a large proportion with unverified stroke had hospital records of other cerebrovascular disease. In both cohorts, higher education was associated with agreement, whereas recent poor mental health was associated with disagreement.

Conclusion: Among women who returned survey questionnaires within the period of interest, validity of self-reported stroke was fair to moderate, but is probably underestimated. Agreement between self-report and hospital-recorded stroke was associated with individual characteristics. Where clinically verified stroke data are unavailable, self-report may be a reasonable alternative method of stroke ascertainment for some epidemiological studies.

Keyword Epidemiology
Cerebrovascular disease
Validation studies
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Public Health Publications
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Created: Wed, 25 Feb 2015, 09:58:41 EST by Dr Leigh Tooth on behalf of School of Public Health