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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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Protein intake and risk of hip fractures in postmenopausal women and men age 50 and older
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“However, the misclassification was likely small, because self-reported hypertension has previously been validated with excellent reliability in both cohorts, and health professionals were more knowledgeable in the types of medications they were taking thus reducing reporting errors.(19,20) Third, a concern in observat…”
BackgroundA prospective study of the validity of self-reported use of specific types of dental services
Gilbert, G. H., Rose, J. S., & Shelton, B. J. (2003) · Public Health Reports · doi:10.1016/s0033-3549(04)50213-3 · Cited by 36
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BackgroundAlcohol Consumption and Mortality among Women
(1997) · New England Journal of Medicine · doi:10.1056/nejm199702133360722 · Cited by 35
Recurrent Trauma in Elderly Patients
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Host risk factors for the development of multiple non‐melanoma skin cancers
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Long-term yogurt consumption and risk of incident hypertension in adults
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Rotating nightshift work and the risk of endometriosis in premenopausal women
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Self-citationPhysical Activity and Inactivity and Risk of Hip Fractures in Men
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Mandel, E. I., Forman, J. P., Curhan, G. C., & Taylor, E. N. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hpt133 · Cited by 33
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“For BCC, we did not seek to obtain the medical records for all, but previous studies have indicated a high validity of self-reports, with >90% confirmed by histopathology records.(19,20) We have the information on body sites for melanoma and SCC but not for BCC.”
ResultLu, D., Qiao, Y., Brown, N. E., & Wang, J. (2017) · PLoS ONE · doi:10.1371/journal.pone.0169679 · Cited by 33
Methylmercury Exposure and Incident Diabetes in U.S. Men and Women in Two Prospective Cohorts
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“Covariates Data on demographics, risk factors, and lifestyle habits were collected via validated self-administered questionnaires, using the closest report preceding toenail sample collection from each participant (18).”
MethodElectric Blanket Use and Breast Cancer in the Nurses' Health Study
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Self-citationStatin use, hyperlipidemia, and risk of glioma
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Self-citationUse of Toenail Fluoride Levels as an Indicator for the Risk of Hip and Forearm Fractures in Women
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Self-citationChoe, S., Lee, J., Lee, J., et al. (2019) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.19.089 · Cited by 32
“However, the PPV for MI in our study was far lower than those in other similar studies [1-3,7,8,10,12,13,16-19].”
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Ma, W., Li, Y., Heianza, Y., Staller, K. D., Chan, A. T., Rimm, E. B., Rexrode, K. M., & Qi, L. (2016) · Scientific Reports · doi:10.1038/srep33005 · Cited by 33
“Hypertension and hypercholesterolemia were self-reported, with the validity of these reports confirmed on random sampling of medical records 38 .”
Duration of Analgesic Use and Risk of Hearing Loss in Women
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“However, data in the present study were prospectively collected over 22 years, and information from this and other similar cohorts has been shown to be highly reliable in previous studies (40, 41, 44, 54).”
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“Furthermore, since the cohort of Danish nurses was established speci fi cally to study risk factors for atherosclerosis, a broad spectrum of risk factors for IHD was available.”
BackgroundManganese superoxide dismutase polymorphism and risk of skin cancer (United States)
Han, J., Colditz, G. A., & Hunter, D. J. (2006) · Cancer Causes & Control · doi:10.1007/s10552-006-0079-6 · Cited by 29
“The validity of self-report of BCC is high in this medically sophisticated population (90%) [14].”
Self-citationCholelithiasis and the Risk of Nephrolithiasis
Taylor, E. N., Chan, A. T., Giovannucci, E. L., & Curhan, G. C. (2011) · The Journal of Urology · doi:10.1016/j.juro.2011.06.067 · Cited by 28
Individualized prevention of proton pump inhibitor related adverse events by risk stratification
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“The accuracy and validity of the disease coding and diagnosis in these cohorts have been veri fi ed in previous studies 60 – 63 .”
Ley, S. H., Sun, Q., Jiménez, M. C., Rexrode, K. M., Manson, J. E., Jensen, M. K., Rimm, E. B., & Hu, F. B. (2013) · Diabetologia · doi:10.1007/s00125-013-3077-8 · Cited by 28
“The validity of these assessments has been documented previously [25].”
BackgroundHistory of Keratinocyte Carcinoma and Risk of Melanoma: A Prospective Cohort Study
Wu, S., Cho, E., Li, W., & Qureshi, A. A. (2017) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djw268 · Cited by 28
“However, previous validation studies reported a high accuracy of selfreported BCC among subsets of cohort participants (96% in women and 84% in men) based on histopathological findings or medical records (19,20).”
MethodHemoglobin A1c, Body Mass Index, and the Risk of Hypertension in Women
Britton, K. A., Pradhan, A. D., Gaziano, J. M., Manson, J. E., Ridker, P. M., Buring, J. E., & Sesso, H. D. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.233 · Cited by 29
Tetracycline use and risk of incident skin cancer: a prospective study
Li, W., Drucker, A. M., Cho, E., et al. (2017) · British Journal of Cancer · doi:10.1038/bjc.2017.378 · Cited by 28
“The BCC diagnoses were not confirmed but previous studies have indicated high validity of selfreports (Colditz et al, 1986; Hunter et al, 1992).”
ResultHow Are Glaucoma Patients Identified?
Quigley, H. A., & JAMPEL, H. D. (2003) · Journal of Glaucoma · doi:10.1097/00061198-200312000-00001 · Cited by 28
Mehta, S. S., Hodgson, M. E., Lunn, R. M., et al. (2023) · Environment International · doi:10.1016/j.envint.2023.108128 · Cited by 27
Birukov, A., Guasch‐Ferré, M., Ley, S. H., Tobias, D. K., Wang, F., Wittenbecher, C., Yang, J., Manson, J. E., Chavarro, J. E., Hu, F. B., et al. (2024) · Diabetes Care · doi:10.2337/dc23-1494 · Cited by 29
The Epidemiology of Urinary Incontinence in Women with Type 2 Diabetes
Devore, E. E., Townsend, M. K., Resnick, N. M., & Grodstein, F. (2012) · The Journal of Urology · doi:10.1016/j.juro.2012.07.027 · Cited by 27
Wei‐Passanese, E. X., Han, J., Lin, W., Li, T., Laden, F., & Qureshi, A. A. (2012) · Photochemistry and Photobiology · doi:10.1111/j.1751-1097.2012.01077.x · Cited by 27
“Validation of BCC selfreporting performed in the cohort populations demonstrated a >90% confirmation rate by histopathology (19,20).”
BackgroundFischer‐Betz, R., Wessel, E. K., Richter, J., et al. (2005) · Zeitschrift für Rheumatologie · doi:10.1007/s00393-005-0644-5 · Cited by 27
Fat Intake and Risk of Skin Cancer in U.S. Adults
Park, M. K., Li, W., Qureshi, A. A., & Cho, E. (2018) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-17-0782 · Cited by 30
“The self-reported cases of BCC demonstrated about 90% of agreement with histopathology records in the previous validation studies for both cohorts (17, 29, 30).”
MethodResultMuntner, P., Coresh, J., Klag, M. J., Whelton, P. K., & Perneger, T. (2002) · American Journal of Kidney Diseases · doi:10.1053/ajkd.2002.34515 · Cited by 25
Pigmentation Traits, Sun Exposure, and Risk of Incident Vitiligo in Women
Dunlap, R., Wu, S., Wilmer, E. N., Cho, E., Li, W., Lajevardi, N., & Qureshi, A. A. (2017) · Journal of Investigative Dermatology · doi:10.1016/j.jid.2017.02.004 · Cited by 26
A Prospective Study of Toenail Trace Element Levels and Risk of Skin Cancer
Matthews, N. H., Koh, M., Li, W., Li, T., Willett, W. C., Stampfer, M. J., Christiani, D. C., Morris, J. S., Qureshi, A. A., & Cho, E. (2019) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-19-0214 · Cited by 29
“Medical records were not obtained for self-reported BCC; however, previous validation studies have demonstrated high validity of self-reported BCC in both cohorts, with 96% of cases in women and 84% of men confirmed by pathology records (36, 37).”
ResultSelf-citationPlasma insulin-like growth factor-1 level and risk of incident hypertension in nondiabetic women
Zhang, L., Curhan, G. C., & Forman, J. P. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e32834103bf · Cited by 26
Relationship of Peripheral Arterial Compliance and Standard Cardiovascular Risk Factors
Willens, H. J., Davis, W. W., Herrington, D. M., Wade, K., Kesler, K. L., Mallon, S., Brown, W. V., Reiber, J. H. C., & Raines, J. K. (2003) · Vascular and Endovascular Surgery · doi:10.1177/153857440303700307 · Cited by 26
Migraine, weight gain and the risk of becoming overweight and obese: A prospective cohort study
Winter, A. C., Wang, L., Buring, J. E., Sesso, H. D., & Kurth, T. (2012) · Cephalalgia · doi:10.1177/0333102412455708 · Cited by 26
“However, our cohort consists of health professionals known to accurately report health information (33).”
BackgroundAre hypertensive women at additional risk of ischaemic heart disease from physically demanding work?
Allesøe, K., Søgaard, K., Aadahl, M., Boyle, E., & Holtermann, A. (2016) · European Journal of Preventive Cardiology · doi:10.1177/2047487316631681 · Cited by 26
Relación entre la red social y la hipertensión arterial en los ancianos españoles
Redondo-Sendino, Á., Guallar‐Castillón, P., Banegas, J. R., & Rodríguez‐Artalejo, F. (2005) · Revista Española de Cardiología · doi:10.1157/13080958 · Cited by 25
Law, M. G., Hurley, S. F., Carlin, J. B., Chondros, P., Gardiner, S., & Kaldor, J. M. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(96)00141-2 · Cited by 26
Hessol, N. A. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.11.1128 · Cited by 25
“However, self-reporting may be inaccurate, depending on the characteristics of the study participant, such as age (1, 2), level of education (2, 3), and substance use (4), or may vary by the type of disease or health event being reported (5).”
BackgroundBusse, P. J., Wang, J., & Halm, E. A. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2005.03.031 · Cited by 25
Zee, R. Y. L., Rivera, A., Inostroza‐Nieves, Y., Ridker, P. M., Chasman, D. I., & Romero, J. R. (2018) · International Journal of Genomics · doi:10.1155/2018/2308585 · Cited by 27
Wei, E. X., Li, X., & Nan, H. (2019) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2019.04.044 · Cited by 25
Scranton, R. E., Sesso, H. D., Stampfer, M. J., Levenson, J. W., Buring, J. E., & Gaziano, J. M. (2004) · American Heart Journal · doi:10.1016/j.ahj.2003.11.018 · Cited by 25
Self-citationWilliams, P. T. (2008) · Obesity · doi:10.1038/oby.2008.299 · Cited by 25
Estimation of life's essential 8 score with incomplete data of individual metrics
Zheng, Y., Huang, T., Guasch‐Ferré, M., Hart, J. E., Laden, F., Chavarro, J. E., Rimm, E. B., Coull, B. A., & Hu, H. Z. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1216693 · Cited by 24
Kim, I. Y., Grodstein, F., Kraft, P., et al. (2019) · PLoS ONE · doi:10.1371/journal.pone.0224975 · Cited by 24
Zhang, Y., Devore, E. E., Strohmaier, S., Grodstein, F., & Schernhammer, E. S. (2019) · BMJ · doi:10.1136/bmj.l6058 · Cited by 26
The effect of climate on fractures and deaths due to falls among white women
Hemenway, D., & Colditz, G. A. (1990) · Accident Analysis & Prevention · doi:10.1016/0001-4575(90)90007-8 · Cited by 24
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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