Agreement between self-report questionnaires and medical record data was substantial for diabetes, hypertension, myocardial infarction and stroke but not for heart failure

J Clin Epidemiol. 2004 Oct;57(10):1096-103. doi: 10.1016/j.jclinepi.2004.04.005.


Objectives: Questionnaires are used to estimate disease burden. Agreement between questionnaire responses and a criterion standard is important for optimal disease prevalence estimates. We measured the agreement between self-reported disease and medical record diagnosis of disease.

Study design and setting: A total of 2,037 Olmsted County, Minnesota residents > or =45 years of age were randomly selected. Questionnaires asked if subjects had ever had heart failure, diabetes, hypertension, myocardial infarction (MI), or stroke. Medical records were abstracted.

Results: Self-report of disease showed >90% specificity for all these diseases, but sensitivity was low for heart failure (69%) and diabetes (66%). Agreement between self-report and medical record was substantial (kappa 0.71-0.80) for diabetes, hypertension, MI, and stroke but not for heart failure (kappa 0.46). Factors associated with high total agreement by multivariate analysis were age <65 years, female sex, education >12 years, and zero Charlson Index score (P < .05).

Conclusion: Questionnaire data are of greatest value in life-threatening, acute-onset diseases (e.g., MI and stroke) and chronic disorders requiring ongoing management (e.g.,diabetes and hypertension). They are more accurate in young women and better-educated subjects.

Publication types

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

MeSH terms

  • Age Factors
  • Aged
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / psychology
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / psychology
  • Disease Progression
  • Educational Status
  • Female
  • Heart Failure / diagnosis
  • Heart Failure / psychology
  • Humans
  • Hypertension / diagnosis
  • Hypertension / psychology
  • Male
  • Medical Records*
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / psychology
  • Prospective Studies
  • Quality of Life*
  • Sensitivity and Specificity
  • Stroke / diagnosis
  • Stroke / psychology
  • Surveys and Questionnaires