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American Journal of Epidemiology Advance Access originally published online on October 25, 2008
American Journal of Epidemiology 2008 168(12):1452-1459; doi:10.1093/aje/kwn279
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

PRACTICE OF EPIDEMIOLOGY

Sensitivity and Specificity of Recalled Vasomotor Symptoms in a Multiethnic Cohort

Sybil L. Crawford, Nancy E. Avis, Ellen Gold, Janet Johnston, Jennifer Kelsey, Nanette Santoro, MaryFran Sowers and Barbara Sternfeld

Correspondence to Dr. Sybil L. Crawford, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Shaw Building Room 228, Worcester, MA 01655 (e-mail: Sybil.Crawford{at}umassmed.edu).

Received for publication March 24, 2008. Accepted for publication August 11, 2008.

Many epidemiologic studies include symptom checklists assessing recall of symptoms over a specified time period. Little research exists regarding the congruence of short-term symptom recall with daily self-reporting. The authors assessed the sensitivity and specificity of retrospective reporting of vasomotor symptoms using data from 567 participants in the Study of Women's Health Across the Nation (1997–2002). Daily assessments were considered the "gold standard" for comparison with retrospective vasomotor symptom reporting. Logistic regression was used to identify predictors of sensitivity and specificity for retrospective reporting of any vasomotor symptoms versus none in the past 2 weeks. Sensitivity and specificity were relatively constant over a 3-year period. Sensitivity ranged from 78% to 84% and specificity from 85% to 89%. Sensitivity was lower among women with fewer symptomatic days in the daily assessments and higher among women reporting vasomotor symptoms in the daily assessment on the day of retrospective reporting. Specificity was negatively associated with general symptom awareness and past smoking and was positively associated with routine physical activity and Japanese ethnicity. Because many investigators rely on symptom recall, it is important to evaluate reporting accuracy, which was relatively high for vasomotor symptoms in this study. The approach presented here would be useful for examining other symptoms or behaviors.

data collection; hot flashes; mental recall; sensitivity and specificity; sweating; vasomotor system

Abbreviations: DHS, Daily Hormone Study; SWAN, Study of Women's Health Across the Nation


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