Comparison of self-reported and biomedical data on hypertension and diabetes: findings from the China Health and Retirement Longitudinal Study (CHARLS).
Comparison of self-reported and biomedical data on hypertension and diabetes: findings from the China Health and Retirement Longitudinal Study (CHARLS).
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DOI：
10.1136/bmjopen-2015-009836
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发表时间：
2016-01-04
期刊：
影响因子：
2.9
通讯作者：
Yang M
中科院分区：
文献类型：
--
作者：
Ning M;Zhang Q;Yang M
我们研究了中国全国社区样本中高血压和糖尿病的生物医学测量值和自我报告测量值之间的一致性程度，并探讨了中国各省和地理区域之间一致性和可能的背景影响之间的关联。对队列样本进行二次分析。社区样本来源于中国健康与养老追踪研究（CHARLS，2011-2012）全国基线调查，通过多阶段概率抽样抽取，其中家庭成员年龄在45岁及以上，样本总数为17 708人。敏感性、特异性和κ被用作一致性或有效性的测量；使用随机效应模型估计各省和社区之间有效性措施的方差。高血压和糖尿病的自我报告显示出较高的特异性（分别为 96.3% 和 98.3%），但敏感性较低（分别为 56.3% 和 61.5%）。对于高血压 (κ 0.57) 和糖尿病 (κ 0.65)，自我报告数据与生物医学测量值之间的一致性中等，年龄较大、社会经济地位较高、受教育程度较高以及在过去 12 个月内入院的受访者显示出比同行更强的一致性。各省之间以及社区之间对高血压和糖尿病的敏感性存在巨大而显着的差异，既不能归因于受访者特征的影响，也不能归因于城乡差异的背景影响。由于总体样本中有相当一部分人不了解自己的病情，自我报告会导致高血压和糖尿病的患病率被低估。然而，在较发达的社区或省份，自我报告的数据可以可靠地估计这两种情况的患病率。对省级和社区层面的背景影响进行进一步调查可以突出公共卫生战略，以提高对这两种情况的认识。
We examined the level of agreement between biomedical and self-reported measurements of hypertension and diabetes in a Chinese national community sample, and explored associations of the agreement and possible contextual effects among provinces and geographic regions in China. Secondary analysis of a cohort sample. Community samples were drawn from the national baseline survey of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2012) through multistage probability sampling, which included households with members 45 years of age or above with a total sample size of 17 708 individuals. Sensitivity, specificity and κ were used as measurements of agreements or validity; variance of validity measures among provinces and communities was estimated using random-effects models. Self-reports for hypertension and diabetes showed high specificity (96.3% and 98.3%, respectively) but low sensitivity (56.3% and 61.5%, respectively). Agreement between self-reported data and biomedical measurements was moderate for both hypertension (κ 0.57) and diabetes (κ 0.65), with respondents who were older, of higher socioeconomic status, better educated and who had hospital admissions in the past 12 months showing stronger agreements than their counterparts. Large and significant variations in the sensitivity among provinces for hypertension, and among communities for both hypertension and diabetes, could neither be attributed to the effects of respondents’ characteristics nor to the contextual effects of city–village differences. As a considerable number of people in the overall sample were unaware of their conditions, self-reports will lead to an underestimation of the prevalence of hypertension and diabetes. However, in more developed communities or provinces, self-reported data can be a reliable estimate of the prevalence of the two conditions. Further investigations of contextual effects at provincial and community levels could highlight public health strategies to improve awareness of the two conditions.