Highlights
- •Sensitivity of self-reported HF was low.
- •Specificity of self-reported HF was high.
- •Agreement of self-reported HF with physician-diagnosed HF was poor.
- •Self-reports of HF are best confirmed by means of diagnostic tests or medical records.
- •There is a need of improved awareness and understanding of HF by patients.
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.
Key Words
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Article info
Publication history
Published online: September 08, 2017
Accepted:
September 1,
2017
Received in revised form:
July 19,
2017
Received:
February 23,
2017
Footnotes
Funding: The Atherosclerosis Risk in Communities Study is a collaborative study supported by National Heart, Lung, and Blood Institute contracts HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C. RC was supported by the National Heart, Lung, and Blood Institute Graduate Research Supplement Diversity Supplement (HHSN268201100007C).
Identification
Copyright
Published by Elsevier Inc.
