自我管理的健康状况问卷是流行病学的重要工具。本验证研究的目的是测量乳腺癌患者的自我报告和他们的医生关于晚期心脏事件的信息之间的一致性。并调查协议的决定因素。估计可能的错误分类是心血管终点观察性研究的重要要求。
回顾,多中心队列研究纳入了1998-2008年在德国诊断为乳腺癌的11,982名女性.2014年，一项问卷调查评估了心血管危险因素和治疗后发生的心脏事件。进行了验证研究，根据来自两家大学医院的3091名乳腺癌患者的样本。其中,2261名妇女（73％）发回了心血管事件调查表，1316名妇女同意要求其全科医生提供医疗记录.总共可以获得1212/1316（92.1％）的医疗记录进行验证。计算了科恩的卡帕系数，和多变量回归用于研究患者特征对两种数据源之间一致性的影响。
任何心脏事件的复合终点的总体一致性为84.5%（κ0.35）。在1055名报告无心脏事件的乳腺癌患者中，950人（90%）在医生的医疗记录中没有这样的诊断。共有157名乳腺癌幸存者表示心脏事件，74名(47%)女性的全科医生证实了同样的诊断.对于特定的诊断，在心肌梗死(kappa0.54)和卒中(kappa0.61)的自我报告中发现了中度至实质的一致性.心绞痛的疗效很差，心脏瓣膜病,心律失常,充血性心力衰竭.年龄更小,研究发现,更高的教育水平和最近的癌症诊断与更大的总体一致性相关.
对于复合端点，乳腺癌幸存者准确报告没有心脏病。然而,对于特定的诊断，乳腺癌患者自我报告的发病率数据可能与医生提供的信息不完全一致.对于心肌梗塞和中风等急性事件，协议是适度的，但对慢性病却很贫穷。
Self-administered health-status questionnaires are important tools in epidemiology. The objective of the presented validation study is to measure the agreement between breast cancer patients\' self-
reports and their physicians\' information on late cardiac events, and to investigate determinants of agreement. To estimate possible misclassification is an important requirement for observational studies on cardiovascular endpoints.
A retrospective, multi-center cohort study included 11,982 women diagnosed with breast cancer in Germany in 1998-2008. In 2014, a questionnaire survey assessed cardiovascular risk factors and incident cardiac events after therapy. A validation study was conducted, based on a sample of 3091 breast cancer patients from two university hospitals. Among them, 2261 women (73%) sent back the questionnaire on cardiovascular events, and 1316 women gave consent to request medical records from their general practitioners. A total of 1212/1316 (92.1%) medical records could be obtained for validation. Cohen\'s kappa coefficient was calculated, and multivariate regression was applied to study the influence of patient characteristics on agreement between both data sources.
Overall agreement for the composite endpoint of any cardiac event was 84.5% (kappa 0.35). Of 1055 breast cancer patients reporting no cardiac event, 950 (90%) had no such diagnosis in physicians\' medical records. A total of 157 breast cancer survivors indicated a cardiac event, and the same diagnosis was confirmed by GPs for 74 (47%) women. For specific diagnoses, moderate to substantial agreement of self-
reports was found for myocardial infarction (kappa 0.54) and stroke (kappa 0.61). Poor to fair agreement was present for angina pectoris, valvular heart disease, arrhythmia, and congestive heart failure. Younger age, higher education and a more recent cancer diagnosis were found to be associated with greater total agreement.
For the composite endpoint, survivors of breast cancer report the absence of cardiac disease accurately. However, for specific diagnoses, self-reported morbidity data from breast cancer patients may not fully agree with information from physicians. The agreement is moderate for acute events like myocardial infarction and stroke, but poor to fair for chronic diseases.
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