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Inaccuracy in self-report of fractures may underestimate association with health outcomes when compared with medical record based fracture registry

Siggeirsdottir, Kristin; Aspelund, Thor; Sigurdsson, Gunnar; Mogensen, Brynjolfur; Chang, Milan; Jonsdottir, Birna; Eiriksdottir, Gudny; Launer, Lenore J.; Harris, Tamara B. and Jonsson, Brynjolfur LU , et al. (2007) In European Journal of Epidemiology 22(9). p.631-639
Abstract
Introduction and objective Misreporting fractures in questionnaires is known. However, the effect of misreporting on the association of fractures with subsequent health outcomes has not been examined. Methods Data from a fracture registry (FR) developed from an extensive review of radiographic and medical records were related to self-report of fracture for 2,255 participants from the AGES Reykjavik Study. This data was used to determine false negative and false positive rates of self-reported fractures, correlates of misreporting, and the potential effect of the misreporting on estimates of health outcomes following fractures. Results In women, the false positive rate decreased with age as the false negative rate increased with no clear... (More)
Introduction and objective Misreporting fractures in questionnaires is known. However, the effect of misreporting on the association of fractures with subsequent health outcomes has not been examined. Methods Data from a fracture registry (FR) developed from an extensive review of radiographic and medical records were related to self-report of fracture for 2,255 participants from the AGES Reykjavik Study. This data was used to determine false negative and false positive rates of self-reported fractures, correlates of misreporting, and the potential effect of the misreporting on estimates of health outcomes following fractures. Results In women, the false positive rate decreased with age as the false negative rate increased with no clear trend with age in men. Kappa values for agreement between FR and self-report were generally higher in women than men with the best agreement for forearm fracture (men 0.64 and women 0.82) and the least for rib (men 0.28 and women 0.25). Impaired cognition was a major factor associated with discordant answers between FR and self-report, OR 1.7 (95% CI: 1.3-2.1) (P < 0.0001). We estimated the effect of misreporting on health after fracture by comparison of the association of the self-report of fracture and fracture from the FR, adjusting for those factors associated with discordance. The weighted attenuation factor measured by mobility and muscle strength was 11% (95% CI: 0-24%) when adjusted for age and sex but reduced to 6% (95% CI: -10-22%) when adjusted for cognitive impairment. Conclusion Studies of hip fractures should include an independent ascertainment of fracture but for other fractures this study supports the use of self-report. (Less)
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Contribution to journal
publication status
published
subject
keywords
registry, function, fracture, questionnaire, self-report, AGES-Reykjavik study
in
European Journal of Epidemiology
volume
22
issue
9
pages
631 - 639
publisher
Springer
external identifiers
  • wos:000249444700008
  • scopus:34548612734
ISSN
1573-7284
DOI
10.1007/s10654-007-9163-9
language
English
LU publication?
yes
id
367e77a5-6d24-4d8e-b827-6a8578167b4b (old id 686668)
date added to LUP
2007-12-14 15:40:16
date last changed
2017-09-10 03:30:37
@article{367e77a5-6d24-4d8e-b827-6a8578167b4b,
  abstract     = {Introduction and objective Misreporting fractures in questionnaires is known. However, the effect of misreporting on the association of fractures with subsequent health outcomes has not been examined. Methods Data from a fracture registry (FR) developed from an extensive review of radiographic and medical records were related to self-report of fracture for 2,255 participants from the AGES Reykjavik Study. This data was used to determine false negative and false positive rates of self-reported fractures, correlates of misreporting, and the potential effect of the misreporting on estimates of health outcomes following fractures. Results In women, the false positive rate decreased with age as the false negative rate increased with no clear trend with age in men. Kappa values for agreement between FR and self-report were generally higher in women than men with the best agreement for forearm fracture (men 0.64 and women 0.82) and the least for rib (men 0.28 and women 0.25). Impaired cognition was a major factor associated with discordant answers between FR and self-report, OR 1.7 (95% CI: 1.3-2.1) (P &lt; 0.0001). We estimated the effect of misreporting on health after fracture by comparison of the association of the self-report of fracture and fracture from the FR, adjusting for those factors associated with discordance. The weighted attenuation factor measured by mobility and muscle strength was 11% (95% CI: 0-24%) when adjusted for age and sex but reduced to 6% (95% CI: -10-22%) when adjusted for cognitive impairment. Conclusion Studies of hip fractures should include an independent ascertainment of fracture but for other fractures this study supports the use of self-report.},
  author       = {Siggeirsdottir, Kristin and Aspelund, Thor and Sigurdsson, Gunnar and Mogensen, Brynjolfur and Chang, Milan and Jonsdottir, Birna and Eiriksdottir, Gudny and Launer, Lenore J. and Harris, Tamara B. and Jonsson, Brynjolfur and Gudnason, Vilmundur},
  issn         = {1573-7284},
  keyword      = {registry,function,fracture,questionnaire,self-report,AGES-Reykjavik study},
  language     = {eng},
  number       = {9},
  pages        = {631--639},
  publisher    = {Springer},
  series       = {European Journal of Epidemiology},
  title        = {Inaccuracy in self-report of fractures may underestimate association with health outcomes when compared with medical record based fracture registry},
  url          = {http://dx.doi.org/10.1007/s10654-007-9163-9},
  volume       = {22},
  year         = {2007},
}