American Journal of Epidemiology Vol. 135, No. 5: 490-499
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
The Accuracy of Self-report of Fractures in Elderly Women: Evidence from a Prospective Study
1Division of Clinical Epidemiology, Department of Epidemiology and Hostatstics, University of California San Francisco, CA
2Department of Medicine, University of California San Francisco, CA
3Division of General Internal Medicine, University of California San Francisco, CA
4General Internal Medicine Section, Veterans Administration Medical Center San Francisco, CA
5Department of Epidemiology, University of Pittsburgh Pittsburgh, PA
6Kaiser-Permanente Center for Health Care Research Portland, OR
Reprint requests to Dr. Michael C. Nevitt, Division of Clinical Epidemiology, University of California, San Francisco, 74 New Montgomery St., Suite 600, San Francisco, CA 94105
The authors compared self-reports of non-spine fractures in a cohort of elderly white women with radiologic reports and medical records. Subjects (n = 9,704) were recruited between 1986 and 1988 in Baltimore, Pittsburgh, Minneapolis, and Portland, Oregon. Eleven percent (95% confidence interval 9–13%) of self-reports of fracture were false-positive (radiographs were negative) and a total of 20% (18–23%) could not be confirmed (radiographs were negative, uncertain, or not available). Report by proxy respondent was more accurate than self-report. There were no confirmed fractures in the medical records of a random sample of 283 participants who did not report a fracture. The percent of false-positives varied by the site of the injury and was low for self-reported fractures of the shoulder or upper arm (5%; 1–13%), wrist (8%; 4–11%), and hip (11%; 5–19%), but was high for hand or finger (20%; 12–30%), rib (23%; 15–32%), and face or skull (33%; 17–54%). Having a college education was associated with increased accuracy, while a history of falls and self-reported osteoporosis were associated with decreased accuracy. The authors conclude that elderly women overreport fractures, but that self-report is relatively accurate for several important osteoporotic fractures, including those of the hip, wrist, and humerus. Self-report of "any" fracture, rib, distal extremity, and head fracture, and fractures in women with a tendency to fall or with osteoporosis should be verified by a radiologic diagnosis.
elderly; epidemiologic methods; fractures; osteoporosis; questionnaires
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Clinton, A. Franta, N. L. Polissar, B. Neradilek, D. Mounce, H. A. Fink, J. T. Schousboe, and F. A. Matsen III Proximal Humeral Fracture as a Risk Factor for Subsequent Hip Fractures J. Bone Joint Surg. Am., March 1, 2009; 91(3): 503 - 511. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Moffett, J. I. Oakley, J. A. Cauley, L. Y. Lui, K. E. Ensrud, B. C. Taylor, T. A. Hillier, M. C. Hochberg, J. Li, S. Cayabyab, et al. Osteoprotegerin Lys3Asn Polymorphism and the Risk of Fracture in Older Women J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 2002 - 2008. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Sogaard, H. E. Meyer, S. Tonstad, L. L. Haheim, and I. Holme Weight Cycling and Risk of Forearm Fractures: A 28-Year Follow-up of Men in the Oslo Study Am. J. Epidemiol., April 15, 2008; 167(8): 1005 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Gerdhem and K. Akesson Rates of fracture in participants and non-participants in the Osteoporosis Prospective Risk Assessment Study J Bone Joint Surg Br, December 1, 2007; 89-B(12): 1627 - 1631. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. T. Schousboe, B. C. Taylor, H. A. Fink, R. L. Kane, S. R. Cummings, E. S. Orwoll, L. J. Melton III, D. C. Bauer, and K. E. Ensrud Cost-effectiveness of Bone Densitometry Followed by Treatment of Osteoporosis in Older Men JAMA, August 8, 2007; 298(6): 629 - 637. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. E. Ensrud, L.-Y. Lui, B. C. Taylor, A. Ishani, M. G. Shlipak, K. L. Stone, J. A. Cauley, S. A. Jamal, D. M. Antoniucci, S. R. Cummings, et al. Renal Function and Risk of Hip and Vertebral Fractures in Older Women Arch Intern Med, January 22, 2007; 167(2): 133 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Shen, J-R Long, D-H Xiong, Y-F Guo, P Xiao, Y-Z Liu, L-J Zhao, Y-J Liu, H-Y Deng, J-L Li, et al. A genomewide scan for quantitative trait loci underlying areal bone size variation in 451 Caucasian families J. Med. Genet., November 1, 2006; 43(11): 873 - 880. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Jakob, F. Marin, E. Martin-Mola, D. Torgerson, P. Fardellone, S. Adami, N.C. Thalassinos, D. Sykes, J. Melo-Gomes, C. Chinn, et al. Characterization of patients with an inadequate clinical outcome from osteoporosis therapy: the Observational Study of Severe Osteoporosis (OSSO) QJM, August 1, 2006; 99(8): 531 - 543. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. T. Wilson, G. A. Chase, E. A. Chrischilles, and R. B. Wallace Hip Fracture Risk Among Community-Dwelling Elderly People in the United States: A Prospective Study of Physical, Cognitive, and Socioeconomic Indicators Am J Public Health, July 1, 2006; 96(7): 1210 - 1218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Rahman, L. Gibney, S. D. Person, O. D. Williams, C. Kiefe, P. Jolly, and J. Roseman Validity of Self-Reports of Reasons for Hospitalization by Young Adults and Risk Factors for Discordance with Medical Records: The Coronary Artery Risk Development in Young Adults (CARDIA) Study Am. J. Epidemiol., September 1, 2005; 162(5): 491 - 498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Moffett, J. M. Zmuda, J. I. Oakley, T. J. Beck, J. A. Cauley, K. L. Stone, L.-Y. Lui, K. E. Ensrud, T. A. Hillier, M. C. Hochberg, et al. Tumor Necrosis Factor-{alpha} Polymorphism, Bone Strength Phenotypes, and the Risk of Fracture in Older Women J. Clin. Endocrinol. Metab., June 1, 2005; 90(6): 3491 - 3497. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Chen, M. Maricic, T. L. Bassford, M. Pettinger, C. Ritenbaugh, A. M. Lopez, D. H. Barad, M. Gass, and M. S. LeBoff Fracture Risk Among Breast Cancer Survivors: Results From the Women's Health Initiative Observational Study Arch Intern Med, March 14, 2005; 165(5): 552 - 558. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. V. Schwartz, M. C. Nevitt, B. W. Brown Jr., and J. L. Kelsey Increased Falling as a Risk Factor for Fracture among Older Women: The Study of Osteoporotic Fractures Am. J. Epidemiol., January 15, 2005; 161(2): 180 - 185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Porthouse, Y.F. Birks, D.J. Torgerson, S. Cockayne, S. Puffer, and I. Watt Risk factors for fracture in a UK population: a prospective cohort study QJM, September 1, 2004; 97(9): 569 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Siris, Y.-T. Chen, T. A. Abbott, E. Barrett-Connor, P. D. Miller, L. E. Wehren, and M. L. Berger Bone Mineral Density Thresholds for Pharmacological Intervention to Prevent Fractures Arch Intern Med, May 24, 2004; 164(10): 1108 - 1112. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Miller, S. Barlas, S. K. Brenneman, T. A. Abbott, Y.-T. Chen, E. Barrett-Connor, and E. S. Siris An Approach to Identifying Osteopenic Women at Increased Short-term Risk of Fracture Arch Intern Med, May 24, 2004; 164(10): 1113 - 1120. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Banks, V. Beral, G. Reeves, A. Balkwill, and I. Barnes Fracture Incidence in Relation to the Pattern of Use of Hormone Therapy in Postmenopausal Women JAMA, May 12, 2004; 291(18): 2212 - 2220. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. A. Hundrup, S. Hoidrup, E. B. Obel, and N. Kr. Rasmussen The validity of self-reported fractures among Danish female nurses: comparison with fractures registered in the Danish National Hospital Register Scand J Public Health, March 1, 2004; 32(2): 136 - 143. [Abstract] [PDF]
|
|
|
|
|
|
S. F. Marshall, D. Deapen, M. Allen, H. Anton-Culver, L. Bernstein, P. L. Horn-Ross, D. Peel, R. Pinder, P. Reynolds, R. K. Ross, et al. Validating California Teachers Study Self-Reports of Recent Hospitalization: Comparison with California Hospital Discharge Data Am. J. Epidemiol., November 15, 2003; 158(10): 1012 - 1020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Ensrud, T. Blackwell, C. M. Mangione, P. J. Bowman, D. C. Bauer, A. Schwartz, J. T. Hanlon, M. C. Nevitt, and M. A. Whooley Central Nervous System Active Medications and Risk for Fractures in Older Women Arch Intern Med, April 28, 2003; 163(8): 949 - 957. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Parikh-Patel, M. Allen, W. E. Wright, and the California Teachers Study Steering Committee Validation of Self-reported Cancers in the California Teachers Study Am. J. Epidemiol., March 15, 2003; 157(6): 539 - 545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. P Trivedi, R. Doll, and K. T. Khaw Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial BMJ, March 1, 2003; 326(7387): 469 - 469. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. J Kalkwarf, J. C Khoury, and B. P Lanphear Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women Am. J. Clinical Nutrition, January 1, 2003; 77(1): 257 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. D. Nelson, J. Rizzo, E. Harris, J. Cauley, K. Ensrud, D. C. Bauer, E. Orwoll, and for the Study of Osteoporotic Fractures Research G Osteoporosis and Fractures in Postmenopausal Women Using Estrogen Arch Intern Med, November 11, 2002; 162(20): 2278 - 2284. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. S. Blaum, M. B. Ofstedal, and J. Liang Low Cognitive Performance, Comorbid Disease, and Task-Specific Disability: Findings From a Nationally Representative Survey J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2002; 57(8): M523 - 531. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Siris, P. D. Miller, E. Barrett-Connor, K. G. Faulkner, L. E. Wehren, T. A. Abbott, M. L. Berger, A. C. Santora, and L. M. Sherwood Identification and Fracture Outcomes of Undiagnosed Low Bone Mineral Density in Postmenopausal Women: Results From the National Osteoporosis Risk Assessment JAMA, December 12, 2001; 286(22): 2815 - 2822. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Chesnut III Osteoporosis, an Underdiagnosed Disease JAMA, December 12, 2001; 286(22): 2865 - 2866. [Full Text] [PDF]
|
|
|
|
|
|
J. A. Cauley, J. M. Zmuda, K. E. Ensrud, D. C. Bauer, and B. Ettinger Timing of Estrogen Replacement Therapy for Optimal Osteoporosis Prevention J. Clin. Endocrinol. Metab., December 1, 2001; 86(12): 5700 - 5705. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. L. Margolis, K. E. Ensrud, P. J. Schreiner, H. K. Tabor, and for the Study of Osteoporotic Fractures Research G Body Size and Risk for Clinical Fractures in Older Women Ann Intern Med, July 18, 2000; 133(2): 123 - 127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Ensrud, T. Duong, J. A. Cauley, R. P. Heaney, R. L. Wolf, E. Harris, S. R. Cummings, and for the Study of Osteoporotic Fractures Research G Low Fractional Calcium Absorption Increases the Risk for Hip Fracture in Women with Low Calcium Intake Ann Intern Med, March 7, 2000; 132(5): 345 - 353. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P Vestergaard, K Krogh, L Rejnmark, S Laurberg, and L Mosekilde Fracture risk is increased in Crohn's disease, but not in ulcerative colitis Gut, February 1, 2000; 46(2): 176 - 181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. E. Ensrud, J. Cauley, R. Lipschutz, and S. R. Cummings Weight Change and Fractures in Older Women Arch Intern Med, April 28, 1997; 157(8): 857 - 863. [Abstract] [PDF]
|
|
|
|
|
|
D. B. Karpf, D. R. Shapiro, E. Seeman, K. E. Ensrud, C. C. Johnston Jr, S. Adami, S. T. Harris, A. C. Santora II, L. J. Hirsch, L. Oppenheimer, et al. Prevention of Nonvertebral Fractures by Alendronate: A Meta-analysis JAMA, April 9, 1997; 277(14): 1159 - 1164. [Abstract] [PDF]
|
|
|
|
|
|
W. S. Browner, A. R. Pressman, M. C. Nevitt, S. R. Cummings, and the Study of Osteoporotic Fractures Research Group Mortality Following Fractures in Older Women: The Study of Osteoporotic Fractures Arch Intern Med, July 22, 1996; 156(14): 1521 - 1525. [Abstract] [PDF]
|
|
|
|
 |
|
 S. R. Cummings, M. C. Nevitt, W. S. Browner, K. Stone, K. M. Fox, K. E. Ensrud, J. Cauley, D. Black, T. M. Vogt, and The Study of Osteoporotic Fractures Research Group Risk Factors for Hip Fracture in White Women N. Engl. J. Med., March 23, 1995; 332(12): 767 - 774. [Abstract] [Full Text] [PDF]
|
|