Validity of self-reported stroke - The Tromso study
Validity of self-reported stroke - The Tromso study
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DOI：
10.1161/01.str.31.7.1602
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发表时间：
2000-07-01
期刊：
影响因子：
8.3
通讯作者：
Viitanen, M
中科院分区：
文献类型：
--
作者：
Engstad, T;Bonaa, KH;Viitanen, M
背景和目的-本研究的目的是验证自我报告的stroke.Methods的诊断，在1994-1995年，27159人参加了人口健康调查，在挪威特罗姆瑟的社区，应答率为77%。共有418名参加者报告了中风史。1997年，所有仍生活在社区的自报中风患者（n=362）被邀请参加临床复查。对于269人谁是复查，一个人谁报告没有中风的历史被选中，并以同样的方式进行复查。结果-复查的基础上，213（79.2%）的自我报告的中风被证实。13人（4.8%）可能有中风。其余43例患者有短暂性脑缺血发作（TIA; n=18）、创伤性头部损伤（n=16）或围产期脑损伤、并发性偏头痛、晕厥、可能的TIA或无出血的脑动脉瘤（n=9）。在确诊的卒中中，30例（14.1%）为出血性，118例（55.4%）为血栓栓塞性。在30例出血中，16例为蛛网膜下出血，10例为动脉瘤破裂。中风的病史，包括症状和体征，往往缺乏细节和准确性，使得无法将65名中风患者（30.5%）分为中风亚型。自报卒中的阳性预测值（PPV）为0.79。男性（0.88）的PPV显著（P=0.016）大于女性（0.73）。年龄大于60岁的个体的PPV显著高于年龄小于60岁的个体（PPV分别为0.83和0.73; P=0.05）。高血压与更大的PPV相关，而缺血性心脏病、糖尿病、肺病或抑郁症病史对PPV无影响。在调查人群中的自报中风的估计敏感性接近80%，特异性为99%.Conclusions-We的结论是，自我管理的问卷调查可以用来评估流行病学研究中的中风的患病率。
Background and Purpose-The aim of this study was to validate the diagnosis of self-reported stroke.Methods During 1994-1995, 27 159 people attended a population health survey in the community of Tromso, Norway, a response rate of 77%. A total of 418 attenders reported a history of stroke. In 1997, all individuals with a self-reported stroke who were still living in the community (n=362) were invited to a clinical reexamination. For each of the 269 people who were reexamined, a person who reported no history of stroke was selected and was reexamined in the same way.Results-On the basis of the reexamination, 213 (79.2%) of the self-reported strokes were confirmed. Thirteen individuals (4.8%) had a possible stroke. The remaining 43 individuals had either transient ischemic attack (TIA; n=18), traumatic head injuries (n=16), or perinatal cerebral damage, complicated migraine, syncope, possible TIA, or cerebral aneurysm without bleeding (n=9). Among the confirmed strokes, 30 (14.1%) were hemorrhagic and 118 (55.4%) were thromboembolic. Of the 30 hemorrhages, 16 were subarachnoidal bleedings, 10 due to ruptured aneurysms. The histories of stroke, including both the symptoms and the signs, often had a paucity of details and precision, making it impossible to classify 65 stroke victims (30.5%) into stroke subtypes. The positive predictive value (PPV) of a self-reported stroke was 0.79. The PPV was significantly (P=0.016) greater in men (0.88) than in women (0.73). Individuals older than 60 years had a significantly greater PPV than those younger than 60 years (PPV 0.83 and 0.73, respectively; P=0.05). Hypertension was associated with a greater PPV, whereas a history of either ischemic heart disease, diabetes mellitus, lung disease, or depression had no impact on the PPV. The estimated sensitivity of self-reported stroke in the survey population was approximate to 80% and the specificity was 99%.Conclusions-We conclude that a self-administered questionnaire can be used to assess the prevalence of stroke in epidemiological research.