Validity and Reliability of Self-reported Diabetes in the Atherosclerosis Risk in Communities Study

Abstract

The objective of this study was to assess the validity of prevalent and incident self-reported diabetes compared with multiple reference definitions and to assess the reliability (repeatability) of a self-reported diagnosis of diabetes. Data from 10,321 participants in the Atherosclerosis Risk in Communities (ARIC) Study who attended visit 4 (1996-1998) were analyzed. Prevalent self-reported diabetes was compared with reference definitions defined by fasting glucose and medication use obtained at visit 4. Incident self-reported diabetes was assessed during annual follow-up telephone calls and was compared with reference definitions defined by fasting glucose, hemoglobin A1c, and medication use obtained during an in-person visit attended by a subsample of participants (n = 1,738) in 2004-2005. The sensitivity of prevalent self-reported diabetes ranged from 58.5% to 70.8%, and specificity ranged from 95.6% to 96.8%, depending on the reference definition. Similarly, the sensitivity of incident self-reported diabetes ranged from 55.9% to 80.4%, and specificity ranged from 84.5% to 90.6%. Percent positive agreement of self-reported diabetes during 9 years of repeat assessments ranged from 92.7% to 95.4%. Both prevalent self-reported diabetes and incident self-reported diabetes were 84%-97% specific and 55%-80% sensitive as compared with reference definitions using glucose and medication criteria. Self-reported diabetes was >92% reliable over time.

Ethnic Specific Obesity Cut-offs for Diabetes Risk: Cross-sectional Study of 489,690 UK Biobank Participants.

“…Indeed, Bays et al reported that the prevalence of diabetes was similar when based solely on self-report in the SHIELD screening survey compared with clinical and laboratory corroboration of self-reports in NHANES (31). Schneider and colleagues also showed that self-reported diabetes was over 92% reliable and 83% sensitive (32). We were unable to differentiate between type 1 and type 2 diabetes.…”

Associação entre cor/raça, obesidade e diabetes em idosos da comunidade: dados do Estudo FIBRA

“…Another limitation is the use of self-reports to evaluate diabetes mellitus, which may lead to an underestimation of the disease's prevalence, since some elderly individuals may be unaware of their diagnosis. In spite of this, in an investigation carried out on 10,321 individuals (average age = 63 years), use of selfreported diabetes had high validity and specificity in the identification of its prevalence and incidence, when compared with standard recommendations, based on fasting plasma glucose levels, glycosylated hemoglobin (HbA1c) and medication use 51 . The method used to classify race may also be considered a limitation, given the subjective and dynamic nature of this criterion based on self-reported skin color.…”

Prevalence of pre-diabetes and type 2 diabetes mellitus among Sami and non-Sami men and women in Northern Norway – The SAMINOR 2 Clinical Survey

“…All the mentioned studies used medical records as reference standard. It should be noted, however, that the phrasing of questions and types of criterion standard affect the sensitivity and positive predictive value of questionnaires [27]. Furthermore, some publications have reported that the Sami people may be more inclined than non-Sami to underreporting diseases due to some cultural differences and/or language barriers (differential misclassification) [28].…”