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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 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]
In the citing paper
“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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Fung, T. T., Stampfer, M. J., Manson, J. E., Rexrode, K. M., Willett, W. C., & Hu, F. B. (2004) · Stroke · doi:10.1161/01.str.0000135762.89154.92 · Cited by 232
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“The diagnosis of diabetes was for the most part based on the response to the question, “Do you have or have you ever had diabetes?” Selfreporting of medical conditions such as diabetes is considered to be reliable (19), and other studies we reviewed also based their analyses on self-reported illness (16,17).”
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“The diagnosis of coronary artery bypass graft surgery was based on self-report, for which the validity had been demonstrated (32).”
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Varraso, R., Fung, T. T., Barr, R. G., Hu, F. B., Willett, W. C., & Camargo, C. A. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.2.488 · Cited by 212
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“In general, previous studies have indicated good agreement between self-reports of fractures and medical records.(1-6) However, the validity of self-reports may vary, depending on skeletal sites,(3,4,6) age, education, previous history of osteoporosis and risk of falls.”
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BackgroundSelf-citationPatients as Reliable Reporters of Medical Care Process: Recall of Ambulatory Encounter Events
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“Existing hypertension and diabetes was confirmed from self reported doctor’s diagnosis, which is generally considered as being reliable (Colditz et al., 1986).”
Using Claims Data for Epidemiologic Research
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Self-citationThe role of calcium supplementation in healthy musculoskeletal ageing
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BackgroundHow Long and How Much Are Nurses Now Working?
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Self-citationBasal-Cell Carcinoma Incidence and Associated Risk Factors in US Women and Men
Wu, S., Han, J., Li, W., Li, T., & Qureshi, A. A. (2013) · American Journal of Epidemiology · doi:10.1093/aje/kwt073 · Cited by 184
Validation of self reported diagnosis of hypertension in a cohort of university graduates in Spain
Alonso, Á., Beunza, J. J., Delgado‐Rodríguez, M., & Martínez‐González, M. Á. (2005) · BMC Public Health · doi:10.1186/1471-2458-5-94 · Cited by 178
“Based in results from the literature, [3,5,6] we assumed that 80% of them would be true cases of HT.”
BackgroundWork-schedule characteristics and reported musculoskeletal disorders of registered nurses
Lipscomb, J. A., Trinkoff, A. M., Geiger-Brown, J. M., & BRADY, B. A. (2002) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.691 · Cited by 181
Wikman, A., Wardle, J., & Steptoe, A. (2011) · PLoS ONE · doi:10.1371/journal.pone.0018952 · Cited by 198
Natarajan, S., Liao, Y., Cao, G., Lipsitz, S. R., & McGee, D. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.14.1735 · Cited by 181
“Also, in a validation study of this cohort, only 68% of self-reported myocardial infarction cases were actually confirmed to have myocardial infarction.(28) In addition, all women did not have uniform assessment for diabetes and thus there may have been contamination of the nondiabetic reference group with undiagnosed…”
MethodCigarette Smoking and the Incidence of Breast Cancer
Xue, F., Willett, W. C., ROSNER, B. A., Hankinson, S. E., & Michels, K. B. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.503 · Cited by 190
Self-citationFrequency of Analgesic Use and Risk of Hypertension in Younger Women
Curhan, G. C., Willett, W. C., ROSNER, B. A., & Stampfer, M. J. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.19.2204 · Cited by 179
“Self-reported diagnosis of hypertension was found to be reliable in a similar cohort of women, the Nurses’ Health Study I.(10) A study participant was considered to have a history of hypertension if she reported high blood pressure on any questionnaire up to and including the 1995 questionnaire; these women were exclu…”
ResultSelf-citationConcordance Between Respondent Self-reports and Medical Records for Chronic Conditions
Skinner, K. M., Miller, D. R., Lincoln, E., Lee, A. F., & Kazis, L. E. (2005) · Journal of Ambulatory Care Management · doi:10.1097/00004479-200504000-00002 · Cited by 181
“The use of either self-administered questionnaires or medical record review in samples of elderly patients offers specific advantages and disadvantages (Colditz et al., 1986; Romm & Putnam, 1981; Verbrugge, 1989).”
MethodSparks, J. A., Chang, S., Liao, K. P., Lü, B., Fine, A., Solomon, D. H., Costenbader, K. H., & Karlson, E. W. (2015) · Arthritis Care & Research · doi:10.1002/acr.22752 · Cited by 184
“validity of self-report in the NHS compared to medical records review has been demonstrated (35).”
BackgroundFlint, A. J., Rexrode, K. M., Hu, F. B., Glynn, R. J., Caspard, H., Manson, J. E., Willett, W. C., & Rimm, E. B. (2010) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2010.01.001 · Cited by 179
Self-citationAssociation Between Endometriosis and Hypercholesterolemia or Hypertension
Mu, F., Rich-Edwards, J., Rimm, E. B., Spiegelman, D., Forman, J. P., & Missmer, S. A. (2017) · Hypertension · doi:10.1161/hypertensionaha.117.09056 · Cited by 180
“The validity of self-reported hypercholesterolemia was assessed by obtaining medical records in a validation study in the original NHS.26 Of the 84 women who reported elevated cholesterol levels and were recontacted, 1 refused to participate in the validation study, and 10 denied the diagnosis.26 Records were obtained…”
BackgroundMethodInfluentialPast use of oral contraceptives and the risk of developing systemic lupus erythematosus
Sánchez‐Guerrero, J., Karlson, E. W., Liang, M. H., Hunter, D. J., Speizer, F. E., & Colditz, G. A. (1997) · Arthritis & Rheumatism · doi:10.1002/art.1780400505 · Cited by 176
Self-citationBorgi, L., Muraki, I., Satija, A., Willett, W. C., Rimm, E. B., & Forman, J. P. (2015) · Hypertension · doi:10.1161/hypertensionaha.115.06497 · Cited by 178
“In NHS, for example, 77% of 51 cases of self-reported hypertension had a BP >160/95 mm Hg.(13) A participant was considered to have prevalent hypertension if she or he reported this diagnosis on any questionnaire up to and including the 1984 (NHS), 1991 (NHS II), or 1986 (HPFS) questionnaire.”
BackgroundSelf-citationNut Consumption and Risk of Cardiovascular Disease
Guasch‐Ferré, M., Liu, X., Malik, V., Sun, Q., Willett, W. C., Manson, J. E., Rexrode, K. M., Li, Y., Hu, F. B., & Bhupathiraju, S. N. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.09.035 · Cited by 185
Self-citationMultiple Diagnostic X-rays for Spine Deformities and Risk of Breast Cancer
Ronckers, C. M., Doody, M. M., Lonstein, J. E., Stovall, M. A., & Land, C. E. (2008) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-07-2628 · Cited by 176
“A personal history of breast cancer is among the most accurately reported cancers across study populations (43, 44).”
BackgroundA Twin Study of Depression Symptoms, Hypertension, and Heart Disease in Middle-Aged Men
Scherrer, J. F., Xian, H., Bucholz, K. K., Eisen, S. A., Lyons, M. J., Goldberg, J. H., Tsuang, M. T., & True, W. R. (2003) · Psychosomatic Medicine · doi:10.1097/01.psy.0000077507.29863.cb · Cited by 175
“Olsson et al. (43) found 100% agreement between hospital record and selfreported myocardial infarction, and in the Nurses’ Health Study (44) there was a 68% agreement between medical record and self-reported heart attack.”
BackgroundBarr, E., Tonkin, A. M., Welborn, T. A., et al. (2009) · Internal Medicine Journal · doi:10.1111/j.1445-5994.2008.01864.x · Cited by 175
Determinants of 24-hour Urinary Oxalate Excretion
Taylor, E. N., & Curhan, G. C. (2008) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01410308 · Cited by 173
Molenaar, E. A., van Ameijden, E. J. C., Grobbee, D. E., & Numans, M. E. (2006) · European Journal of Public Health · doi:10.1093/eurpub/ckl113 · Cited by 172
Smoking and the Risk of Incident Hypertension in Middle-aged and Older Men
Halperin, R. O., Gaziano, J. M., & Sesso, H. D. (2008) · American Journal of Hypertension · doi:10.1038/ajh.2007.36 · Cited by 176
Comparison of Interleukin-6 and C-Reactive Protein for the Risk of Developing Hypertension in Women
Sesso, H. D., Wang, L., Buring, J. E., Ridker, P. M., & Gaziano, J. M. (2006) · Hypertension · doi:10.1161/01.hyp.0000252664.24294.ff · Cited by 172
A Prospective Study of Overall Diet Quality and Risk of Type 2 Diabetes in Women
Fung, T. T., McCullough, M. L., van Dam, R. M., & Hu, F. B. (2007) · Diabetes Care · doi:10.2337/dc06-2581 · Cited by 177
GARROW, A. (2004) · Pain · doi:10.1016/s0304-3959(04)00210-6 · Cited by 172
Prospective Study of Moderate Alcohol Consumption and Risk of Hypertension in Young Women
Thadhani, R., Camargo, C. A., Stampfer, M. J., Curhan, G. C., Willett, W. C., & Rimm, E. B. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.5.569 · Cited by 166
“The false-positive rate was examined in a sample of 100 nurses reporting a diagnosis of high blood pressure.(15) Sixty-two gave permission to review their medical records, and complete records were obtained for 51 women.”
BackgroundSelf-citationStampfer, M. J., Colditz, G. A., & Willett, W. C. (1990) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1990.tb30329.x · Cited by 170
Self-citation
Metadata
- 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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