MISCLASSIFICATION OF SMOKING STATUS IN THE CARDIA STUDY - A COMPARISON OF SELF-REPORT WITH SERUM COTININE LEVELS
MISCLASSIFICATION OF SMOKING STATUS IN THE CARDIA STUDY - A COMPARISON OF SELF-REPORT WITH SERUM COTININE LEVELS
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DOI：
10.2105/ajph.82.1.33
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发表时间：
1992-01-01
影响因子：
12.7
通讯作者：
FRIEDMAN, GD
中科院分区：
文献类型：
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作者：
WAGENKNECHT, LE;BURKE, GL;FRIEDMAN, GD
背景 虽然在流行病学研究中广泛使用，但自我报告已被证明低估了某些人群中吸烟的患病率。 在CARDIA研究中，吸烟的自我报告与尼古丁摄取的生化标志物血清可替宁进行了验证。 吸烟的患病率在自我报告定义时（30.9%）略低于可替宁水平等于或大于14 ng/mL定义时（32.2%，P <0.05）。 错误分类率（报告的可替宁水平至少为14 ng/mL的非吸烟者比例）为4.2%，黑人受试者、高中教育程度或以下受试者或报告的既往吸烟者的错误分类率显著较高。 错误分类的可能原因包括报告错误，环境烟草烟雾，和一个不适当的截止点划定吸烟states.Using自我报告作为金标准，可替宁的截止点，最大限度地提高灵敏度和特异性分别为14，9和15 ng/mL的所有，白色，和黑色的主题，分别。 使用这些种族特异性标准，黑人的错误分类率显著高于白色受试者。 在这些年轻人中，通过自我报告对吸烟的错误分类很低;然而，在某些种族/教育群体中，自我报告可能会低估吸烟率高达4%。
Background. Although widely used in epidemiological studies, self-report has been shown to underestimate the prevalence of cigarette smoking in some populations.Methods. In the CARDIA study, self-report of cigarette smoking was validated against a biochemical marker of nicotine uptake, serum cotinine.Results. The prevalence of smoking was slightly lower when defined by self-report (30.9%) than when defined by cotinine levels equal to or greater than 14 ng/mL (32.2%, P < .05). The misclassification rate (proportion of reported nonsmokers with cotinine levels of at least 14 ng/mL) was 4.2% and was significantly higher among subjects who were Black, had a high school education or less, or were reported former smokers. Possible reasons for misclassification include reporting error, environmental tobacco smoke, and an inappropriate cutoff point for delineation of smoking status.Using self-report as the gold standard, the cotinine cutoff points that maximized sensitivity and specificity were 14, 9, and 15 ng/mL for all, White, and Black subjects, respectively. The misclassification rate remained significantly higher in Black than in White subjects using these race-specific criteria.Conclusion. Misclassification of cigarette smoking by self-report was low in these young adults; however, within certain race/education groups, self-report may underestimate smoking prevalence by up to 4%.