Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women
Abstract
To assess the validity of self-reported illnesses, medical records were reviewed for participants reporting major illnesses on the biennial follow-up questionnaires used in a prospective cohort study which began in 1976. In over 90% of cases of cancer of the breast, skin, large bowel, and thyroid, histopathology reports confirmed the subjects' self-report. Lower levels of confirmation were obtained for cancers of the lung, ovary, and uterus. Application of strict diagnostic criteria also gave lower levels of confirmation for myocardial infarction (68%) and stroke (66%). Among random samples of women reporting fractures and hypertension all records obtained confirmed self-reports. For self-reported elevated cholesterol levels 85.7% of self-reports were confirmed. Self-report is a valuable epidemiologic tool but may require additional documentation when the disease is diagnostically complex.
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The moderately increased lung and colorectal cancer mortality among women with ≥15 years of night shift work is consistent with previous reports on incident lung and colorectal cancer in the same cohort.
“The moderately increased lung and colorectal cancer mortality among women with ≥15 years of night shift work is consistent with previous reports on the risk of developing incident lung and colorectal among night shift–working women in the same cohort.58,59”
From Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts (2015) · cites this paper as [59]
Self-reported hypertension was found to have high validity compared with medical records; of 51 women who reported hypertension and had medical records, hypertension (blood pressure >140/90) was confirmed in all cases.
“Of 85 women we sampled from NHS who had reported high blood pressure and responded to a validation questionnaire, only one denied elevated blood pressure (reporting that she in fact had hypotension).(21) Self reported hypertension was found to have high vaildity compared to the medical records. Of 51 women who reported hypertension for whom we were able to obtain medical records, hypertension (bl”
From Infertility, fertility treatment, and risk of hypertension (2015) · cites this paper as [21]
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Self-citationPostmenopausal Estrogen Therapy and Cardiovascular Disease
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Self-citationImpact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period
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“34,35 The exposure assessments lacked information on intensity of night shift work and physiological measures that may be affected by shift work.”
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“The limitations of the current study include that the blood pressures of participants were not directly measured, and the diagnosis of hypertension was self-reported; however, all participants were health professionals, and hypertension reporting by participants of these cohorts was highly sensitive (19).”
BackgroundSelf-citationWalking and Leisure-Time Activity and Risk of Hip Fracture in Postmenopausal Women
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“We inquired about physician-diagnosed hypertension and high cholesterol every 2 years; these self-reports were highly accurate compared with medical records in a validation study (25).”
MethodSelf-citationModerate Alcohol Consumption and the Risk of Breast Cancer
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Self-citationMethods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study
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Self-citationValidation of diagnostic codes within medical services claims
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Self-citationProspective Study of Nutritional Factors, Blood Pressure, and Hypertension Among US Women
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“In a similar population of the Nurses’ Health Study, these self-reported covariates were found to be reasonable valid in a validation study of this cohort [20].”
Migraine, headache, and the risk of stroke in women
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Self-citationRisk of symptomatic gallstones in women with severe obesity
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Self-citationDASH-Style Diet Associates with Reduced Risk for Kidney Stones
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Excess mortality after hip fracture in elderly persons from Europe and the USA : the CHANCES project
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Measures of Obesity and Cardiovascular Risk Among Men and Women
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“Validation against medical records has also shown that hypertension is accurately self-reported by HPFS participants,(22) and although the soundness of self-reported hypercholesterolemia has not been assessed in the HPFS, it has been successfully validated in a cohort of nurses using the same biennial questionnaire.(2…”
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MethodHealthy Lifestyle in the Primordial Prevention of Cardiovascular Disease Among Young Women
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Self-citationProtein Consumption and Bone Fractures in Women
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Self-citation
- Authors
- COLDITZ, G. A., MARTIN, P., STAMPFER, M. J., WILLETT, W. C., SAMPSON, L., ROSNER, B., HENNEKENS, C. H., & SPEIZER, F. E.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- COLDITZ, GRAHAM A.
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1986-05
- Volume
- 123
- Issue
- 5
- Pages
- 894-900
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W1958805324
- Cited by
- 992
- References
- 0
- Citations by year
- 2026: 13 · 2025: 10 · 2024: 19 · 2023: 25 · 2022: 23 · 2021: 17 · 2020: 27 · 2019: 22 · 2018: 32 · 2017: 40 · 2016: 49 · 2015: 48 · 2014: 40 · 2013: 36 · 2012: 45
- FWCI
- 35.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL24074, HL34594)
- National Cancer Institute (CA-16686)
- Topics
- Social Sciences › Sociology and Political Science › Survey Methodology and Nonresponse
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- questionnaire validation, self-reported illness, breast cancer, skin cancer, thyroid cancer, lung cancer, ovarian cancer, uterine cancer, myocardial infarction, stroke, fracture, hypertension, cholesterol levels, women, risk factors, disease outcome
- MeSH terms
- Adult, Blood Pressure, Cardiovascular Diseases, Cholesterol, Epidemiologic Methods, Female, Follow-Up Studies, Humans, Hypertension, Medical Records, Middle Aged, Morbidity, Neoplasms, Surveys and Questionnaires, United States, Fractures, Bone
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