Validity of self-reported eye disease and treatment in a population-based study: the Los Angeles Latino Eye Study

Ophthalmology. 2012 Sep;119(9):1725-30. doi: 10.1016/j.ophtha.2012.02.029. Epub 2012 Apr 25.

Abstract

Purpose: To examine the validity of self-reported eye disease, including cataract, age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR), and self-reported surgical treatment for cataract and DR in the Los Angeles Latino Eye Study (LALES).

Design: Population-based, cross-sectional study.

Participants: A total of 6357 Latinos aged 40+ years from the LALES.

Methods: Participants underwent a detailed interview, including survey questions about ocular health, diagnoses, and timing of last eye examination, and a standardized clinical examination. Self-report was compared with examination to determine sensitivity and specificity by length of time since last eye examination. Stepwise logistic regression was used to determine factors associated with inaccurate self-report.

Main outcome measures: Sensitivity and specificity were calculated for 4 self-reported eye diseases (cataract, AMD, glaucoma, and DR) and for surgical treatment of cataract and DR. Odds ratios (ORs) were determined for factors associated with inaccurate self-report underestimating eye disease and treatment.

Results: For each disease, sensitivity and specificity in those who reported their last eye examination as <1 year ago were 36.8% and 92.5% for cataract, 37.7% and 96.3% for glaucoma, 5.1% and 98.9% for AMD, and 25.7% and 94.2% for DR, respectively. Self-report was less accurate with increasing time since last eye examination. Inaccurate self-report was independently associated with better visual acuity (OR, 2.4), <2 comorbidities (OR, 1.7), last eye examination/visit 1 to 5 years ago and ≥ 5 years ago (OR, 2.3 and 4.9, respectively), and less education (OR, 1.3 for 7-12 years and 1.7 for <7 years). Of 88 participants surgically treated for cataract who reported an eye examination <1 year ago, sensitivity and specificity of self-reported surgical history were 90.9% and 99.9%, respectively. Of the 31 participants treated for DR (laser/surgery) and reporting an eye examination <1 year ago, sensitivity and specificity of self-reported surgical history were 19.4% and 99.6%, respectively.

Conclusions: Among Latinos, self-reporting of eye disease and surgical history provides a significant underestimate of the disease burden. This may lead to significant misclassification in vision research if self-report alone is used to identify persons with eye disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Cataract / ethnology
  • Cataract Extraction
  • Cost of Illness
  • Cross-Sectional Studies
  • Diabetic Retinopathy / ethnology
  • Diabetic Retinopathy / surgery
  • Eye Diseases / ethnology*
  • Eye Diseases / surgery*
  • Glaucoma / ethnology
  • Health Surveys
  • Hispanic Americans / ethnology*
  • Humans
  • Los Angeles / epidemiology
  • Macular Degeneration / ethnology
  • Physical Examination / statistics & numerical data
  • Self Report*
  • Sensitivity and Specificity
  • Surveys and Questionnaires
  • Vision Tests / statistics & numerical data
  • Visual Acuity / physiology