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L. E. Patty, S. Wu, M. Torres, R. Varma, LALES Group; Validity of Self-Reported Diagnosis and Treatment Among Latinos in the Los Angeles Latino Eye Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5358.
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To examine the accuracy of self-reported diagnosis of cataract, age-related macular degeneration (ARMD), glaucoma, and diabetic retinopathy (DR) and self-reported surgical treatment of cataract and DR in the Los Angeles Latino Eye Study (LALES).
The LALES is a population-based study of adult Latinos in Los Angeles. Participants underwent a detailed interview and eye examination, including self-reported survey questions about ocular health and diagnoses. In-home interviewers obtained information such as demographics, risk factors, history of ocular/medical conditions, eye care utilization, employment, acculturation, and insurance status. A standardized clinical exam was performed, including a dilated eye exam, blood pressure, random glucose, and visual acuity measurement. Sensitivity, specificity, and positive predictive values (PPV) were calculated for 4 self-reported ophthalmic conditions (cataract, ARMD, glaucoma, and DR) and laser/surgical treatment of cataract and DR. Univariate and multivariate logistic analyses were used to determine factors associated with accurate self-reporting.
Of 1068 participants diagnosed with cataract, sensitivity of self-reporting was 27%, specificity 96%, and PPV 58%. Of 574 with ARMD, sensitivity was 3%, specificity 99%, PPV 35%. Of 283 with glaucoma, sensitivity was 24%, specificity 98%, PPV 38%. Of 516 with DR, sensitivity was 21%, specificity 94%, PPV 79%. In multivariate logistic analysis, higher acculturation score (OR 1.9), more barriers to eye care (OR 2.1), poorer general health/visual acuity (OR 5.0/3.3), ≥2 comorbidities (OR 6.8), and a dilated eye exam within the last 5 years (OR 3.5) were significantly associated with greater accuracy of self-reporting of diagnosis. Of 200 participants surgically treated for cataract (OS), sensitivity of self-reporting was 83%, specificity 99.9%, PPV 99%. Of 44 treated for DR (laser/surgery OS), sensitivity was 30%, specificity 99.8%, PPV 52%. In multivariate analysis, men were less likely to correctly report cataract surgery than women (OR 0.5).
Sensitivity and PPV of self-reported diagnosis and treatment of major ophthalmic conditions among adult Latinos were low. A notable exception was cataract surgery, which had high sensitivity and PPV. Participants’ self-report of disease was poorly correlated with their actual diagnoses, indicating a need for greater awareness of ocular diagnoses/treatment in this population. In ophthalmic research on Latinos, clinical exam over self-reporting should be used to determine ocular history.
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