Validity of a self-reported history of doctor-diagnosed angina
Validity of a self-reported history of doctor-diagnosed angina
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DOI：
10.1016/s0895-4356(98)00146-2
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发表时间：
1999-01-01
影响因子：
7.2
通讯作者：
Ebrahim, S
中科院分区：
文献类型：
--
作者：
Lampe, FC;Walker, M;Ebrahim, S
这项研究的目的是评估男性人群研究中自我报告的医生诊断的心绞痛病史的有效性。受试者是5789名来自英国区域心脏研究的男性，他们报告说在入院时(1978-1980)没有心绞痛诊断，他们在1992年底活着，年龄在52到75岁之间。1992年，受试者在一份自填式问卷中被问及他们是否记得曾被医生诊断为心绞痛。将诊断为心绞痛的自我报告与从研究开始至1992年底查阅病历获得的心绞痛的全科(GP)记录进行比较。从1992年开始，男性因主要的缺血性心脏病事件而被跟踪调查了3年。1992年心绞痛的患病率根据自我报告史为10.1%，根据全科医生记录回顾为8.9%。这两个信息来源之间有很大的一致性：80%有心绞痛全科医生记录的男性报告了他们的诊断，70%报告心绞痛诊断的男性从记录审查中确认了这一点。当考虑所有的缺血性心脏病(心绞痛或心肌梗死)时，符合率更高。在177名自我报告的心绞痛患者中，许多人可能是真正的心绞痛，这些人没有被GP记录审查证实：78人有缺血性心脏病病史(心肌梗死或冠状动脉血运重建)，31人在1992年后有心绞痛记录。心绞痛症状、硝酸盐使用、心脏病学调查和手术治疗心绞痛在协议组之间的比较显示出非常一致的模式。所有这些心绞痛指标在既有心绞痛自我报告又有一般家庭医生记录的男性中最常见，在既没有自我报告心绞痛又没有家庭医生心绞痛记录的男性中最不常见，但只有自我报告心绞痛的男性的患病率显著高于仅有家庭医生心绞痛记录的男性。从1992年开始，经过3年的随访，同时有心绞痛和GP记录的男性中有9.5%的人经历过新的重大缺血性心脏病事件，而自我报告有心绞痛的男性中有11.3%的人经历过新的重大缺血性心脏病事件；相比之下，按照这两种标准，只有心绞痛和普通心绞痛记录的男性的这一比例为5.7%，而没有心绞痛的男性为2.7%。在对年龄和既往心肌梗死进行调整后，这种风险模式仍然相似。这些结果表明，在以人群为基础的男性研究中，医生自我报告的心绞痛病史是诊断心绞痛的有效手段。《CLIN流行病学杂志》52；1：73-81,1999。(C)1999年爱思唯尔科学公司。
The objective of this study was to assess the validity of a self-reported history of doctor-diagnosed angina in population-based studies in men. Subjects were 5789 men from the British Regional Heart Study who reported being without an angina diagnosis at entry (1978-1980) and were alive at the end of 1992, aged 52 to 75 years. In 1992, subjects were asked in a self administered questionnaire if they recalled ever having had a doctor diagnosis of angina. Self-report of diagnosed angina was compared with general practice (GP) record of angina obtained from reviews of medical records from study entry to the end of 1992. Men were followed for a further 3 years from 1992 for major ischemic heart disease events. The prevalence of diagnosed angina in 1992 was 10.1% according to self-reported history and 8.9% according to GP record review. There was substantial agreement between the two sources of information: 80% of men with a GP record of angina reported their diagnosis, and 70% of men who reported an angina diagnosis had confirmation of this from the record review. When all ischemic heart disease (angina or myocardial infarction) was considered, agreement was higher. Genuine angina was likely in many of the 177 men who had self-reported angina not confirmed by the GP record review: 78 had an ischemic heart disease history (myocardial infarction or coronary revascularization) identified by the review, and 31 had a GP record of angina after 1992. Angina symptoms, nitrate use, cardiological investigation, and surgical intervention for angina compared between agreement groups showed a very consistent pattern. All these indicators of angina were most common in men with both self-report and GP record of angina, least common in men with neither self-report nor GP record of angina, but had a substantially higher prevalence in men with self-reported angina only than in those with GP-recorded angina only. After 3 years follow-up from 1992, 9.5% of men with both self report and GP record of angina, and 11.3% of men with self-reported angina only had experienced a new major ischemic heart disease event; compared to 5.7% of men with a GP record of angina only and 2.7% of those without angina by either criteria. This pattern of risk remained similar after adjustment for age and previous myocardial infarction. These results suggest that self-reported history of a doctor diagnosis of angina is a valid measure of diagnosed angina in population-based studies in men. J CLIN EPIDEMIOL 52;1:73-81, 1999. (C) 1999 Elsevier Science Inc.