Self-reported health parameters compared with clinician measurements: methods in practice-based research

J Public Health Manag Pract. 2014 Sep-Oct;20(5):513-22. doi: 10.1097/PHH.0b013e3182a998fd.

Abstract

Context: Self-reported health data are used by health insurance companies to assess risk. Most studies show underreporting compared with clinical measurements.

Objective: To compare self-reported height, weight, blood pressure, waist circumference, and dietary intake with registered dietitian's (RD's) measures of the same parameters.

Design: This is a secondary analysis of data collected in a larger study on the benefits of Medical Nutrition Therapy from an RD for overweight and obese patients when provided free of charge through an insurance benefit.

Setting: Participants completed a health risk assessment survey at home, from which the self-reported measures were extracted. The clinical measurements were taken by an RD in the office during a visit for Medical Nutrition Therapy.

Participants: Participants were 81.4% female, with a mean body mass index of 35.0. All were insured and had a least 1 visit with an RD.

Main outcome measure(s): Main outcomes were correlation between self-reported and RD-measured height, weight, body mass index, blood pressure, and waist circumference. Blood pressure was categorized as normal or high and the κ statistic was used to examine category agreement between the 2 measures. Servings of food groups were compared between the 2 measures by examining cumulative percent within 0, 1, or 2 servings of the RD-measured value.

Results: The 2 measures of height and weight were highly correlated (0.974 and 0.986, respectively). Blood pressure was more weakly correlated and when categorized had low κ scores, as did servings of food groups.

Conclusions: Height and weight were more closely correlated than in previous studies. In an insured population enrolled in a weight management program, self-reported measures may be accurate for determining program impact. Blood pressure may be better collected categorically than continuously. The necessity of food intake assessment on a risk assessment should be reconsidered.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure
  • Body Height
  • Body Mass Index
  • Body Weight
  • Cross-Sectional Studies
  • Energy Intake
  • Female
  • Health Status Indicators*
  • Humans
  • Male
  • Middle Aged
  • North Carolina
  • Nutritionists*
  • Obesity / epidemiology
  • Obesity / prevention & control*
  • Overweight / epidemiology
  • Overweight / prevention & control*
  • Risk Assessment
  • Self Report*
  • Surveys and Questionnaires
  • Waist Circumference