Validity of Self-Report of Cardiovascular Risk Factors in a Population at High Risk for Stroke
Validity of Self-Report of Cardiovascular Risk Factors in a Population at High Risk for Stroke
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DOI：
10.1016/j.jstrokecerebrovasdis.2015.08.022
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发表时间：
2015-12-01
影响因子：
2.5
通讯作者：
Boulos, Mark I.
中科院分区：
文献类型：
--
作者：
Dey, Ayan K.;Alyass, Akram;Boulos, Mark I.
背景：血管危险因素的筛查通常通过自我报告进行评估，尽管有报道称在健康人群中使用这种方法的敏感性较低。中风高危人群自我报告的血管危险因素的有效性仍有待探讨。目的：本研究调查了近期有高危短暂性脑缺血发作或轻微中风病史的患者群体中自我报告的心血管危险因素（例如高血压、高胆固醇血症和 II 型糖尿病）的有效性。方法：从患者问卷答复和医疗记录中提取数据（n = 101）。使用每个血管危险因素的敏感性、特异性以及阳性和阴性预测值的估计来评估自我报告和临床测量（血压、空腹血糖、血脂和活性药物）之间的一致性。结果：49% 的研究人群不准确地自我报告了至少 1 种血管危险因素。高血压、高胆固醇血症和糖尿病的自我报告敏感性分别为 84.5%（置信区间 [CI]：72.1-92.2）、57.5%（CI：44.1-69.7）和 77.8%（CI：57.3-90.6），而特异性为 76.7%（CI：分别为 61.0-87.7)、83.3% (CI: 67.3-93.2) 和 95.4% (CI: 87.8-98.9)。高胆固醇血症自我报告的准确性显着低于糖尿病 (P < .001) 和高血压 (P < .05)，其中 42.6% 的高胆固醇患者漏报了诊断。逻辑回归显示，年轻人和男性准确自我报告的几率更大。结论：这些结果强调临床医生、科学家和流行病学家在使用自我报告措施筛查血管危险因素时需要谨慎，因为与目标措施的交叉验证显示敏感性较差。我们的结果还凸显出缺乏对这些重要条件的公众教育。
Background: Screening for vascular risk factors is commonly assessed through self-report, despite reports of low sensitivity using this approach in healthy populations. The validity of self-reported vascular risk factors in a population at high risk for stroke has yet to be explored. Aims: This study investigated the validity of self-reported cardiovascular risk factors (e.g., hypertension, hypercholesterolemia, and type II diabetes mellitus) in a population of patients with a recent history of high-risk transient ischemic attack or minor stroke. Methods: Data were extracted from patient questionnaire responses and medical records (n = 101). Agreement between self-report and clinical measures (blood pressure, fasting blood glucose, lipid profile, and active medications) was assessed using estimates of sensitivity, specificity, and positive and negative predictive values for each vascular risk factor. Results: Forty-nine percent of the study population inaccurately self-reported at least 1 vascular risk factor. Sensitivities of self-report for hypertension, hypercholesterolemia, and diabetes were 84.5% (confidence interval [CI]: 72.1-92.2), 57.5% (CI: 44.1-69.7), and 77.8% (CI: 57.3-90.6), respectively, while specificities were 76.7% (CI: 61.0-87.7), 83.3% (CI: 67.3-93.2), and 95.4% (CI: 87.8-98.9), respectively. Accuracy of self-report for hypercholesterolemia was significantly lower than that for diabetes (P < .001) and hypertension (P < .05), with 42.6% of those with high cholesterol under-reporting their diagnosis. Logistic regression revealed that odds of accurate self-report were greater among younger adults and males. Conclusions: These results highlight the need for clinicians, scientists, and epidemiologists to be cautious when screening for vascular risk factors using self-report measures as cross validation against objectives measures reveals poor sensitivity. Our results also highlight a lack of public education concerning these significant conditions.