Author:
Burvill Angela J,Murray Kevin,Knuiman Matthew W,Hung Joseph
Abstract
Abstract
Background
Population health behaviour and risk factor surveys most often rely on self-report but there is a lack of studies assessing the validity of self-report using Australian data. This study investigates the sensitivity, specificity and agreement of self-reported hypertension and hypercholesterolaemia with objective measures at standard and more stringent diagnostic thresholds; and factors associated with sensitivity and specificity of self-report at different thresholds.
Methods
This study was a secondary analysis of a representative community-based cross-sectional sample of 5,092 adults, aged 45–69 years, residing in Busselton, Western Australia, surveyed in 2010–2015. Participants completed a self-administered questionnaire. Blood pressure and serum cholesterol levels were measured.
Results
At currently accepted diagnostic thresholds, sensitivities of self-reported hypertension and hypercholesterolaemia were 58.5% and 39.6%, respectively and specificities were >90% for both. Agreement using Cohen’s kappa coefficient was 0.562 and 0.223, respectively. At two higher diagnostic thresholds, sensitivities of self-reported hypertension and hypercholesterolaemia improved by an absolute 14–23% and 15–25%, respectively and specificities remained >85%. Agreement was substantial for hypertension (kappa = 0.682–0.717) and moderate for hypercholesterolaemia (kappa = 0.458–0.533). Variables that were independently associated with higher sensitivity and lower specificity of self-report were largely consistent across thresholds and included increasing age, body mass index, worse self-rated health, diabetes and family history of hypertension.
Conclusions
Self-reported hypertension and hypercholesterolaemia often misclassify individuals’ objective status and underestimate objective prevalences, at standard diagnostic thresholds, which has implications for surveillance studies that rely on self-reported data. Self-reports of hypertension, however, may be reasonable indicators of those with blood pressures ≥160/100 mmHg or those taking anti-hypertensive medications. Self-reported hypercholesterolaemia data should be used with caution at all thresholds.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Internal Medicine
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