Agreement between self-reported and register-based cardiovascular events among Danish breast cancer survivors

Langballe, Rikke; John, Esther M.; Malone, Kathleen E.; Bernstein, Leslie; Knight, Julia A.; Lynch, Charles F.; Howell, Rebecca M.; Shore, Roy E.; Woods, Meghan; Concannon, Patrick; Bernstein, Jonine L.; Mellemkjær, Lene

doi:10.1007/s11764-017-0648-6

Cited by 10 publications

(8 citation statements)

References 17 publications

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“…Our results show that earlier reports can be confirmed in a different health care system. In a validation study with 357 Danish breast cancer patients who conducted a telephone-interview on cardiovascular diseases (CVD) [ 14 ], the authors found a high accuracy (94%) for reporting the absence of CVD, comparing self-reports and diagnostic codes from the Danish National Patient Register. This is in line with our and previous studies, who showed a high accuracy of recall for participants who did not report a CVD [ 15 – 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Complex diagnostic criteria and closely related cardiac symptoms could make it difficult for patients to report specific diagnoses accurately. Combining closely related cardiac diseases (angina pectoris and myocardial infarction) may increase the validity of self-reports [ 14 , 17 ]. Accordingly, in our validation study single cardiac diseases were combined to a comprehensive item.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, the accuracy of morbidity data from patient self-reports is determined by multiple factors including patients’ characteristics, reporting methods, type of diagnosis and presence of distinct disease criteria. Furthermore, different comparison tools could impede the comparability of published results [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

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Cardiac late events in German breast cancer patients: a validation study on the agreement between patient self-reports and information from physicians

Merzenich

Blettner

Niehoff

et al. 2018

BMC Cardiovasc Disord

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BackgroundSelf-administered health-status questionnaires are important tools in epidemiology. The objective of the presented validation study is to measure the agreement between breast cancer patients’ self-reports and their physicians’ information on late cardiac events, and to investigate determinants of agreement. To estimate possible misclassification is an important requirement for observational studies on cardiovascular endpoints.MethodsA retrospective, multi-center cohort study included 11,982 women diagnosed with breast cancer in Germany in 1998–2008. In 2014, a questionnaire survey assessed cardiovascular risk factors and incident cardiac events after therapy. A validation study was conducted, based on a sample of 3091 breast cancer patients from two university hospitals. Among them, 2261 women (73%) sent back the questionnaire on cardiovascular events, and 1316 women gave consent to request medical records from their general practitioners. A total of 1212/1316 (92.1%) medical records could be obtained for validation. Cohen’s kappa coefficient was calculated, and multivariate regression was applied to study the influence of patient characteristics on agreement between both data sources.ResultsOverall agreement for the composite endpoint of any cardiac event was 84.5% (kappa 0.35). Of 1055 breast cancer patients reporting no cardiac event, 950 (90%) had no such diagnosis in physicians’ medical records. A total of 157 breast cancer survivors indicated a cardiac event, and the same diagnosis was confirmed by GPs for 74 (47%) women. For specific diagnoses, moderate to substantial agreement of self-reports was found for myocardial infarction (kappa 0.54) and stroke (kappa 0.61). Poor to fair agreement was present for angina pectoris, valvular heart disease, arrhythmia, and congestive heart failure. Younger age, higher education and a more recent cancer diagnosis were found to be associated with greater total agreement.ConclusionsFor the composite endpoint, survivors of breast cancer report the absence of cardiac disease accurately. However, for specific diagnoses, self-reported morbidity data from breast cancer patients may not fully agree with information from physicians. The agreement is moderate for acute events like myocardial infarction and stroke, but poor to fair for chronic diseases.Electronic supplementary materialThe online version of this article (10.1186/s12872-018-0961-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cardiac late events in German breast cancer patients: a validation study on the agreement between patient self-reports and information from physicians

Merzenich

Blettner

Niehoff

et al. 2018

BMC Cardiovasc Disord

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“…This is the first study to report that the agreement between self-reported and provider-reported comorbidities among older hospitalized patients with heart failure is generally poor. Though a direct comparison was not performed, the agreements of hypertension, diabetes mellitus, COPD, and coronary artery disease were numerically lower in patients with heart failure compared with the general elderly population, [1][2][3] patients with cancer, [10][11][12] and patients with chronic kidney disease, 13,14 which may be due to a variety of reasons. As the FRAGILE-HF study focused on older patients with heart failure, the patient population in this study included older patients, and age is a strong predictor of disagreement between patient reports and medical records regarding the presence or absence of comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 The understanding and recognition of one's own comorbidities is an essential and fundamental aspect of patient education. 7 Studies on the general population, [1][2][3]8,9 patients with cancer, [10][11][12] and patients with chronic kidney disease 13,14 have reported that patients do not necessarily recognize their own comorbid conditions that are recorded in their medical records and that the agreement between self-reported and provider-reported comorbidities is generally poor. The accuracy of self-reported comorbidities among patients with heart failure has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Inaccurate recognition of own comorbidities is associated with poor prognosis in elderly patients with heart failure

et al. 2022

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Aims A patient's understanding of his or her own comorbidities is part of the recommended patient education for those with heart failure. The accuracy of patients' understanding of their comorbidities and its prognostic impact have not been reported. Methods and resultsPatients hospitalized for heart failure (n = 1234) aged ≥65 years (mean age: 80.1 ± 7.7 years; 531 females) completed a questionnaire regarding their diagnoses of diabetes, malignancy, stroke, hypertension, chronic obstructive pulmonary disease (COPD), and coronary artery disease (CAD). The patients were categorized into three groups based on the number of agreements between self-reported comorbidities and provider-reported comorbidities: low (1-2, n = 19); fair (3-4, n = 376); and high (5-6, n = 839) agreement groups. The primary outcome was a composite of all-cause mortality or heart failure rehospitalization at 1 year. The low agreement group had more comorbidities and a higher prevalence of a history of heart failure. The agreement was good for diabetes (κ = 0.73), moderate for malignancy (κ = 0.56) and stroke (κ = 0.50), and poor-to-fair for hypertension (κ = 0.33), COPD (κ = 0.25), and CAD (κ = 0.30). The fair and low agreement groups had poorer outcomes than the good agreement group [fair agreement group: hazard ratio (HR): 1.25; 95% confidence interval (CI): 1.01-1.56; P = 0.041; low agreement group: HR: 2.74: 95% CI: 1.40-5.35; P = 0.003]. Conclusions The ability to recognize their own comorbidities among older patients with heart failure was low. Patients with less accurate recognition of their comorbidities may be at higher risk for a composite of all-cause mortality or heart failure rehospitalization.

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Are self-reported medical conditions and medicine use from middle-aged and older adults credible? A validation study comparing Danish SHARE-data with National Health Register data

Mose,

Jensen,

Scheel-Hincke

et al. 2023

Annals of Epidemiology

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Agreement between self-reported and register-based cardiovascular events among Danish breast cancer survivors

Cited by 10 publications

References 17 publications

Cardiac late events in German breast cancer patients: a validation study on the agreement between patient self-reports and information from physicians

Cardiac late events in German breast cancer patients: a validation study on the agreement between patient self-reports and information from physicians

Inaccurate recognition of own comorbidities is associated with poor prognosis in elderly patients with heart failure

Are self-reported medical conditions and medicine use from middle-aged and older adults credible? A validation study comparing Danish SHARE-data with National Health Register data

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