The validity of self-reported fractures among Danish female nurses: comparison with fractures registered in the Danish National Hospital Register
Abstract
BACKGROUND: The authors compared self-reported non-spine fractures obtained from a cohort of Danish female nurses with fracture diagnoses registered in the Danish National Hospital Register (DNHR). METHOD: The self-reported fracture history was obtained from a questionnaire and was related to fracture information registered with the DNHR by means of the unique person identification code of Danish citizens. A total of 166 self-reported hip fractures, 391 self-reported wrist fractures, and 121 self-reported upper arm fractures were available for the comparison. The self-reported fractures were initially compared with the anatomic specific fracture diagnoses registered in the DNHR. Second, the comparison also included fracture diagnoses of adjacent skeletal sites (unspecific fracture diagnoses). RESULTS: The positive predictive value of a positive report of hip fracture was 89%. Inclusion of unspecific registered hip fractures increased the positive predictive value to 94%. The same figures for wrist fractures were 75% and 84%, respectively, and for upper arm fractures 54% and 83%, respectively. The predictive value of a negative report of hip fracture was 99.5%. The fracture year was correctly reported in 76% of the hip fracture cases, 81% of the wrist fracture cases, and 82% of the upper arm fracture cases. Predictors of false-positive report of fractures were young age ( < 60 years), report of indoor falls in the previous year, and use of hormone replacement therapy (HRT). CONCLUSION: The authors conclude that self-report of hip, wrist, or upper arm fractures among Danish nurses is relatively accurate but varies by the site of fracture. False positive reports of fracture introduce only modest bias fracture risk estimates and tend to dilute the association between exposures and fracture.
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The register has been validated for hip fracture outcomes.
“The register has been validated for hip fracture outcomes (25) and has been extensively used in fracture epidemiology.”
Capture of fracture outcomes using national health databases is generally very good for hip fractures but vertebral fractures are regularly missed by healthcare providers.
“Capture of fracture outcomes using national health databases is generally very good for hip fractures, (25,38) but vertebral fractures are regularly missed by healthcare providers.”
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- Authors
- Hundrup, Y. A., Høidrup, S., Obel, E. B., & Rasmussen, N. K.
- Affiliations
- Danish National Institute of Public Health (DK)
- Copenhagen University Hospital (DK)
- Venue
- Scandinavian Journal of Public Health
- Publisher
- SAGE Publications
- Published
- 2004-03
- Volume
- 32
- Issue
- 2
- Pages
- 136-143
- ISSN
- 1403-4948 (ISSN-L)
- 1651-1905
- OpenAlex
- W1967626536
- Cited by
- 76
- References
- 22
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 2 · 2022: 4 · 2021: 5 · 2020: 4 · 2019: 5 · 2018: 3 · 2017: 4 · 2016: 5 · 2015: 3 · 2014: 8 · 2013: 2 · 2012: 2
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Scandinavian Journal of Public Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Surgery › Hip and Femur Fractures
- Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
- Keywords
- hip fracture, wrist fractures, upper arm fractures, female nurses, positive predictive value, hormone replacement therapy, falls, fracture risk prediction
- MeSH terms
- Aged, Denmark, False Positive Reactions, Female, Humans, Middle Aged, Nurses, Registries, Self Disclosure, Reproducibility of Results, Fractures, Bone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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