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Validity of self-reported prevalent cases of stroke and acute myocardial infarction in the Spanish cohort of the EPIC study
  1. Monica Machón1,2,
  2. Larraitz Arriola1,2,
  3. Nerea Larrañaga1,2,
  4. Pilar Amiano1,2,
  5. Concepción Moreno-Iribas2,3,4,
  6. Antonio Agudo5,
  7. Eva Ardanaz2,3,
  8. Aurelio Barricarte2,3,
  9. Genevieve Buckland5,
  10. MªDolores Chirlaque2,6,
  11. Diana Gavrila2,6,
  12. José María Huerta2,6,
  13. Carmen Martínez2,7,
  14. Esther Molina2,7,
  15. Carmen Navarro2,6,
  16. José Ramón Quiros8,
  17. Laudina Rodríguez8,
  18. María José Sanchez2,7,
  19. Carlos Alberto González5,
  20. Miren Dorronsoro1,2
  1. 1Public Health Department of Gipuzkoa, Basque Government, San Sebastian, Spain
  2. 2CIBER in Epidemiology and Public Health (CIBERESP), Barcelona, Spain
  3. 3Public Health Institute of Navarra, Pamplona, Spain
  4. 4Doctoral degree programme at Autonomous University of Barcelona (UAB), Obstetrics and Gynaecology and Preventive Medicine, Barcelona, Spain
  5. 5Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Barcelona, Spain
  6. 6Department of Epidemiology, Murcia Health Council, Murcia, Spain
  7. 7Andalusian School of Public Health, Granada, Spain
  8. 8Public Health and Health Planning Directorate, Asturias, Spain
  1. Correspondence to Dr Larraitz Arriola, Public Health Department of Gipuzkoa, Basque government, Avenida Navarra 4, San Sebastian 20003, Spain; l-arriola{at}


Background Information on the validity of self-reported cases of stroke and acute myocardial infarction (AMI) is varied. The aim of this study was to assess the validity and agreement of self-reported prevalent cases of stroke and AMI in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC).

Methods At recruitment, 1992–1996, and in the follow-up (3 years after recruitment), each participant in the Spanish EPIC cohort (15 630 men and 25 808 women) was asked if a doctor had ever said that they had had a stroke or AMI, and the results were compared with information available in medical records. Validity of self-reported prevalent cases of stroke and AMI was examined by calculating sensitivity, specificity, positive predictive values and κ statistics.

Results The sensitivity of self-reported prevalent cases of stroke was 81.3% and that for AMI was 97.7%. The positive predictive value was 22.2% and 60.7% for stroke and AMI, respectively, whereas specificity was very high (>99%) for both diseases. The agreement between self-report questionnaire results and medical records was substantial (κ=0.75) for AMI but not for stroke (κ=0.35).

Conclusion Self-reported information on stroke and AMI included in the EPIC questionnaire is a valid instrument for the assessment of AMI disease but should be used with caution in stroke.

  • Stroke
  • acute myocardial infarction
  • sensitivity
  • specificity
  • positive predictive value
  • κ statistic
  • EPIC
  • cancer
  • coronary heart disease
  • ischaemic heart disease
  • epidemiology
  • vascular disease
  • public health
  • chronic DI
  • diabetes
  • ischaemic heart disease
  • nutrition
  • CHD/coronary heart
  • communicable diseases

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  • Funding This work was supported by the CIBER in Epidemiology and Public Health (AC07_010). The EPIC study received financial support from the European Commission (Agreement SO 97 200302 05F02), the participating Regional Governments, the Red Temática de Investigación Cooperativa de Centros de Cáncer (RTICCC, C03/10) and the International Agency for Research on Cancer (Agreement AEP/93/02).

  • Competing interests None.

  • Ethics approval The study was approved by a local ethical review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.