Validity of self-report of fractures: Results from a prospective study in men and women across Europe
Validity of self-report of fractures: Results from a prospective study in men and women across Europe
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DOI：
10.1007/s001980050288
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发表时间：
2000-01-01
影响因子：
4
通讯作者：
Silman, AJ
中科院分区：
文献类型：
--
作者：
Ismail, AA;O'Neill, TW;Silman, AJ
在基于人群的骨质疏松症研究中，骨折的确定通常基于自我报告，随后通过医疗记录进行验证。本分析的目的是评估使用邮寄问卷自我报告非脊柱骨折事件的有效性。通过比较多中心欧洲前瞻性骨质疏松症研究中受访者新发骨折的自我报告与其他来源（包括X线片和病历）的数据，评估骨折多报（假阳性）的程度。在分析中，563例受试者报告了非脊柱骨折。在510名受试者中可以验证骨折的存在。其中，11%的骨折未被证实（假阳性）。男性的假阳性率高于女性（15% vs 9%，p=0.04），前臂远端和髋部骨折的假阳性率低于其他部位骨折。在一项单独的研究中，通过对251名确诊骨折的个体进行随访，对漏报（假阴性）的程度进行了评估，这些患者是从三个欧洲中心（吕贝克、奥维耶多、华沙）的骨折诊所的记录中确定的。从174例（69%）受试者中收到问卷答复。其中，12例（7%）不记得骨折（假阴性）。髋关节和前臂远端骨折的假阴性率较低，90例此类骨折中只有3例（3%）未回忆起。使用两项研究的综合数据，在问卷上报告骨折“日期”的受试者中，91%的受试者在骨折实际日期的1个月内正确。邮寄问卷调查是一种相对简单和准确的方法，用于获得有关髋部和前臂远端骨折发生的信息，包括其发生时间。在其他部位确定骨折的准确性较差，在可能的情况下，这些部位的自我报告骨折应通过其他来源进行验证。
In population-based studies of osteoporosis, ascertainment of fractures is typically based on self-report, with subsequent verification by medical records. The aim of this analysis was to assess the validity of self-report of incident nonspine fractures using a postal questionnaire. The degree of overreporting of fracture (false positives) was assessed by comparing self-reports of new fracture from respondents in the multicenter European Prospective Osteoporosis Study with data from other sources including radiographs and medical records. In the analysis, 563 subjects reported nonspine fractures. Verification of the presence of fracture was possible in 510 subjects. Of these, fractures were not confirmed in 11% (false positives). The percentage of false positives was greater in men than in women (15% vs 9%, p=0.04), and less for fractures of the distal forearm and hip than for fractures at other sites. In a separate study, the degree of underreporting (false negatives) was assessed by follow-up of 251 individuals with confirmed fracture ascertained from the records of fracture clinics in three European centers (Lubeck, Oviedo, Warsaw. Questionnaire responses were received from 174 (69%) subjects. Of these, 12 (7%) did not recall sustaining a fracture (false negatives). The percentage of false negatives was lower for hip and distal forearm fractures with only 3 of 90 (3%) such fractures not recalled. Using the combined data from both studies, of those who reported a 'date' of fracture on the questionnaire, 91% of subjects were correct to within 1 month of the actual date of the fracture. A postal questionnaire is a relatively simple and accurate method fur obtaining information about the occurrence of hip and distal forearm fractures, including their timing. Accuracy of ascertainment of fractures at other sites is less good and where possible self-reported fractures at such sites should be verified from other sources.