RESEARCH - Validation of self-report of RA and SLE: The Women's Health Initiative

[Guest guest]

J Rheumatol. 2008 Apr 1

Validation of Self-Report of Rheumatoid Arthritis and Systemic Lupus

Erythematosus: The Women's Health Initiative.

Walitt BT, Constantinescu F, Katz JD, Weinstein A, Wang H,

RK, Hsia J, BV.

From the Washington Hospital Center and Washington University

Hospital, Washington, DC; and MedStar Research Institute, Hyattsville,

land, USA.

OBJECTIVE: The Women's Health Initiative (WHI), initiated in 1993,

enrolled 161,808 postmenopausal women aged 50-79 years and followed

them with annual questionnaires for 8 years in order to study major

causes of morbidity and mortality. Our objective was to determine the

most effective and efficient means to validate self-reported

rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in

the WHI. METHODS: Data from 2 of 40 WHI clinical centers were used. Of

these 7443 women, 643 self-reported RA and 106 self-reported SLE.

Research coordinators contacted these women using mailers and

telephone calls to obtain medical record releases and a Connective

Tissue Screening Questionnaire (CSQ). Medical records were obtained on

286 self-reported RA and 34 self-reported SLE and reviewed by 3

rheumatologists blind to the self-reported diagnoses. Sensitivity,

specificity, and the kappa statistic were computed to evaluate the

level of agreement between self-report and chart review. RESULTS:

Self-reported RA was accurate only 14.7% (42/286 cases) of the time.

Coupling the self-report to medication data improved the positive

predictive value (PPV; 62.2%) and kappa (0.53), suggesting a moderate

agreement to chart review. Self-reported SLE was accurate only 11.8%

(4/34 cases) of the time. Coupling the self-report to medication data

improved the PPV (40.0%) and kappa (0.44), suggesting a moderate

agreement to chart review. The CSQ was inferior to using medication

data but was substantially better than self-report alone. CONCLUSION:

The performance of disease self-report coupled with medication history

in validating RA and SLE was very good and should obviate the need for

time-consuming medical record reviews.

PMID: 18398940

http://www.ncbi.nlm.nih.gov/pubmed/18398940

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