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22. European Stroke Conference Table 1 Self-reported and hospitalised stroke in each cohort Cohort Agreement Older (born 1921-26) Hospital-recorded stroke Yes No Total Self-re-ported stroke Yes 25 77 102 No 7 1447 1454 To-tal 32 1524 1556 Mid-age (born 1946-52) Hospital-recorded stroke Yes No Total Self-re-ported stroke Yes 11 14 25 No 3 2091 2094 To-tal 14 2105 2119 Table 2 Agreement between self-report and hospitalised stroke Cohort Agreement measures Older Mid-age Prevalence (self-report) 6.6% 1.2% Prevalence (hospital-recor-ded) 2% 0.7% Sensitivity 78.1% 78.6% Specificity 94.9% 99.3% Positive predictive value 24.5% 44.0% Negative predictive value 99.5% 99.9% 0.35 (0.25 to Kappa (95% CI) 0.46) 0.56 (0.37 to 0.75) Prevalence index 0.91 0.98 6 Epidemiology of stroke 15:20 - 15:30 Moderate agreement between self-reported stroke and hospital-recorded stroke in two co-horts of Australian women: a validation study C.A. Jackson1, G.D. Mishra2, J Byles3, L Tooth4, A Dobson5 University of Queensland, Brisbane, AUSTRALIA1,University of Queensland, Brisbane, AUSTRALIA2, University of Newcastle, Newcastle, AUSTRALIA3, University of Queensland, Brisbane, AUSTRALIA4, University of Queensland, Brisbane, AUSTRALIA5 Background There is uncertainty around using self-reported stroke in epidemiological studies, with conflicting recommendations from prior studies. We compared self-reported with hospi-tal- recorded stroke, and investigated reasons for disagreement. Methods We included women from the Australian Longitudinal Study on Women’s Health, who lived in New South Wales and returned 3-yearly surveys between 2001-10 (mid-age cohort; N = 2119, mean age 53) or 2002-08 (older cohort; N = 1556, mean age 78). We determined agree-ment between self-report and hospitalised stroke by calculating sensitivity, specificity, positive and negative predictive values (PPVs, NPVs) and kappa statistics, and determined factors asso-ciated with disagreement. Results Women reported 102 and 23 strokes in the older and mid-age cohorts respectively. Sensitivity and specificity were high. Few women failed to report hospital-recorded strokes (NPV>99% in both cohorts) but many reported an unverified stroke, particularly in the older cohort where the PPV was 25% compared with 44% in the mid-age cohort. This was partly due to: reporting of transient ischaemic attack (TIA); strokes occurring outside the period of interest; and possible reporting of stroke-like events. A third of older women with an unveri-fied stroke did have a cerebrovascular disease diagnosis (including TIAs) and 18% provided additional survey comments with details of the stroke. Agreement was therefore fair in older women (kappa 0.35, 95% CI 0.25 to 0.46) and moderate in mid-age women (0.56, 95% CI 0.37 to 0.75). In both cohorts higher education was associated with agreement. Recent poor mental health was associated with disagreement. Conclusion Validity of self-reported stroke is fair to moderate in our study, but is probably underestimated due to comparison with hospital data only. Where routinely collected data are unavailable, self-reported stroke may be a reasonable alternative method of ascertainment for some epidemiological studies. 142 © 2013 S. Karger AG, Basel Scientific Programme


Karger_ESC London_2013
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