Validity of diabetes self-reports in the Women's Health Initiative: comparison with medication inventories and fasting glucose measurements
Validity of diabetes self-reports in the Women's Health Initiative: comparison with medication inventories and fasting glucose measurements
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DOI：
10.1177/1740774508091749
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发表时间：
2008-01-01
期刊：
影响因子：
2.7
通讯作者：
Phillips, Lawrence S.
中科院分区：
文献类型：
--
作者：
Margolis, Karen L.;Qi, Lihong;Phillips, Lawrence S.
目的虽然糖尿病是方便地评估自我报告，很少验证研究已经进行。因此，我们研究了妇女健康倡议（WHI）参与者的自我报告的流行和事件糖尿病是否与其他诊断证据的diabetes.Study设计和设置共161808绝经后妇女年龄在50-79岁，在1993-1998年在美国的40个临床中心参加，并进行前瞻性随访。基线时，糖尿病治疗的流行药物定义为医生诊断和胰岛素或口服降糖药物治疗的自我报告。在随访期间，事件治疗糖尿病定义为接受胰岛素或口服药物治疗的新医生诊断糖尿病的自我报告。糖尿病自我报告进行了比较，药物库存和空腹血糖水平在基线和follow-up.Results在基线时，自我报告的治疗糖尿病与药物库存在79%的临床试验，77%的观察性研究参与者是一致的。在临床试验中，基线和第1年之间的自我报告事件治疗糖尿病与药物库存一致率为78%，在临床试验中，第1年和第3年之间的一致率为62%，在观察性研究中，基线和第3年之间的一致率为72%。在相似的时期内，99.9%未报告治疗糖尿病的患者在药物清单中没有口服降糖药物或胰岛素。基线时，约3%未报告糖尿病的受试者空腹血糖>126 mg/dl，其中88%的受试者随后在6.9年的随访期间报告了接受治疗的糖尿病。局限性仅通过生活方式治疗的自我报告糖尿病事件并未在WHI中确定。药物库存可能是不完整的，空腹血糖可能已经降低了治疗，因此，一致性与自我报告的治疗或空腹血糖>= 126可能被低估。结论在WHI，自我报告的流行和事件糖尿病是一致的药物库存，和高比例的未确诊糖尿病随后报告糖尿病治疗。“糖尿病治疗”的自我报告足够准确，可以用于流行病学研究。
Objective Although diabetes is conveniently assessed by self-report, few validation studies have been performed. Therefore, we studied whether self-report of prevalent and incident diabetes in Women's Health Initiative (WHI) participants was concordant with other diagnostic evidence of diabetes.Study Design and Setting A total of 161808 postmenopausal women aged 50-79 were enrolled at 40 clinical centers in the U.S. in 1993-1998 and followed prospectively. At baseline, prevalent medication treated diabetes was defined as a 5elf-report of physician diagnosis and treatment with insulin or oral antidiabetic drugs. During followup, incident treated diabetes was defined as a self-report of a new physician diagnosis of diabetes treated with insulin or oral drugs. Diabetes self-reports were compared with medication inventories and fasting glucose levels at baseline and during follow-up.Results At baseline, self-reported treated diabetes was concordant with the medication inventory in 79% of clinical trial, and 77% of observational study participants. Self-reported incident treated diabetes was concordant with the medication inventory in 78% between baseline and Year 1 in the clinical trials, in 62% between Year 1 and Year 3 in the clinical trials, and in 72% between baseline and Year 3 in the observational study. Over similar periods, 99.9% of those who did not report treated diabetes had no oral antidiabetic drugs or insulin in the medication inventory. At baseline, about 3% not reporting diabetes had fasting glucose >126 mg/dl, and 88% of these subjects subsequently reported treated diabetes during 6.9 years of follow-up.Limitations Incident self-reported diabetes treated by lifestyle alone was not determined in WHI. Medication inventories may have been incomplete and fasting glucose may have been lowered by treatment; therefore, concordance with self-reported treatment or fasting glucose >= 126 may have been underestimated.Conclusion In the WHI, self-reported prevalent and incident diabetes was consistent with medication inventories, and a high proportion of those with undiagnosed diabetes subsequently reported diabetes treatment. Self-reports of 'treated diabetes' are sufficiently accurate to allow use in epidemiologic studies.