Accuracy of Patient Self-Report of Stroke: A Systematic Review from the UK Biobank Stroke Outcomes Group

Rebecca Woodfield, Biobank Stroke Outcomes Group Uk, UK Biobank Follow-up and Outcomes Working Group and Cathie L M Sudlow

PLOS ONE, 2015, vol. 10, issue 9, 1-14

Abstract: Objective: We performed a systematic review of the accuracy of patient self-report of stroke to inform approaches to ascertaining and confirming stroke cases in large prospective studies. Methods: We sought studies comparing patient self-report against a reference standard for stroke. We extracted data on survey method(s), response rates, participant characteristics, the reference standard used, and the positive predictive value (PPV) of self-report. Where possible we also calculated sensitivity, specificity, negative predictive value (NPV), and stroke prevalence. Study-level risk of bias was assessed using the Quality Assessment of Diagnostic Studies tool (QUADAS-2). Results: From >1500 identified articles, we included 17 studies. Most asked patients to report a lifetime history of stroke but a few limited recall time to ≤5 years. Some included questions for transient ischaemic attack (TIA) or stroke synonyms. No study was free of risk of bias in the QUADAS-2 assessment, the most frequent causes of bias being incomplete reference standard data, absence of blinding of adjudicators to self-report status, and participant response rates ( 75% in all but one study. It was not possible to assess the influence of recall time or of the question(s) asked on PPV or sensitivity. Conclusions: Characteristics of the study population strongly influence self-report accuracy. In population-based studies with low stroke prevalence, a large proportion of self-reported strokes may be false positives. Self-report is therefore unlikely to be helpful for identifying cases without subsequent confirmation, but may be useful for case ascertainment in combination with other data sources.

Date: 2015
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0137538

DOI: 10.1371/journal.pone.0137538

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