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J Card Fail. 2017 Nov;23(11):802-808. doi: 10.1016/j.cardfail.2017.09.002. Epub 2017 Sep 8.

Accuracy of Self-Reported Heart Failure. The Atherosclerosis Risk in Communities (ARIC) Study.

Author information

1
Center for Health Equity, Northern Arizona University, Flagstaff, Arizona; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States of America. Electronic address: ricky.camplain@nau.edu.
2
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, United States of America.
3
Department of Medicine, The University of North Carolina, Chapel Hill, North Carolina, United States of America.
4
Center for Predictive Medicine, Duke Clinical Research Institute, Durham, North Carolina, United States of America.
5
Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States of America.
6
Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America.

Abstract

OBJECTIVE:

The aim of this work was to estimate agreement of self-reported heart failure (HF) with physician-diagnosed HF and compare the prevalence of HF according to method of ascertainment.

METHODS AND RESULTS:

ARIC cohort members (60-83 years of age) were asked annually whether a physician indicated that they have HF. For those self-reporting HF, physicians were asked to confirm their patients' HF status. Physician-diagnosed HF included surveillance of hospitalized HF and hospitalized and outpatient HF identified in administrative claims databases. We estimated sensitivity, specificity, positive predicted value, kappa, prevalence and bias-adjusted kappa (PABAK), and prevalence. Compared with physician-diagnosed HF, sensitivity of self-report was low (28%-38%) and specificity was high (96%-97%). Agreement was poor (kappa 0.32-0.39) and increased when adjusted for prevalence and bias (PABAK 0.73-0.83). Prevalence of HF measured by self-report (9.0%), ARIC-classified hospitalizations (11.2%), and administrative hospitalization claims (12.7%) were similar. When outpatient HF claims were included, prevalence of HF increased to 18.6%.

CONCLUSIONS:

For accurate estimates HF burden, self-reports of HF are best confirmed by means of appropriate diagnostic tests or medical records. Our results highlight the need for improved awareness and understanding of HF by patients, because accurate patient awareness of the diagnosis may enhance management of this common condition.

KEYWORDS:

Heart failure; administrative claims; medical records; self-report

PMID:
28893677
PMCID:
PMC5671356
DOI:
10.1016/j.cardfail.2017.09.002
[Indexed for MEDLINE]
Free PMC Article

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