Validation of Self-Reported Transfusion Histories in Renal Dialysis Patients

By Sandhu, Jat S; Campbell, Patricia M et al. | Canadian Journal of Public Health, May/June 1999 | Go to article overview

Validation of Self-Reported Transfusion Histories in Renal Dialysis Patients


Sandhu, Jat S, Campbell, Patricia M, Preiksaitis, Jutta K, Carriere, Keumhee C, Hessel, Patrick A, Canadian Journal of Public Health


ABSTRACT

The purpose of this analysis was to assess the validity of self-reported transfusion histories in dialysis patients. Using data from a crosssectional study of a dialysis population being investigated for hepatitis C virus (HCV) infection, the correspondence between self-reported transfusion history and transfusion records was explored. Demographic data and dialysis histories were examined in relation to the accuracy of self-reports. Overall, the questionnaire data and the blood bank records agreed for 89% of participants. The Kappa statistic was 0.72 (95% CI: 0.61, 0.83) indicating an acceptable level of agreement. The effect of non-differential exposure misclassification on the risk estimates for transfusion history as a determinant of HCV infection is demonstrated. Exploring the discrepancies between self-reports and documented transfusion histories underlines the need to communicate clearly medical interventions in chronically ill patients. Additionally, it suggests that studies into transfusion-acquired bloodborne pathogens should use all available information sources to establish exposure.

A B R E G E

Cette analyse avait pour but d'evaluer la validite des antecedents auto-delares de transfusion chez les patients dialyses. A partir des donnees provenant d'une analyse transversale sur des patients dialyses pour deteuer les cas d'infecton au virus de l'hepatite C (VHC), on a etudie la correspondance entre les antecedents autodeclares de transfusion et les dossiers en attestant. Les donnees demographiques et les ant&cedents de dialyse ont ete etudids par rapport a l'exactitude des auto-declarations. De facon generale, les donnees du questionnaire et les dossiers des banques de sang concordaient pour 89 % des participants. Le resultat de l'analyse statistique Kappa etait 0,72 (95 % IC: 0,61 0,83) indiquant un niveau de concordance acceptable. On a demontre l'effet des erreurs de classification de l'exposition non differentielle sur les estimations du risque pour les antecedents de transfusion comme determinant de l'infection au VHC. L'examen des disparites entre les auto-declarations et les antecedents de transfusion documentes souligne la necessite de communiquer les interventions medicales subies par des malades chroniques. En outre, cela suggere que les etudes faites sur les pathogenes a diffusion hematogene transmis par des transfusions devraient utiliser routes les sources d'information disponibles pour etablir l'exposition.

Blood transfusions were commonly given to patients with end-stage renal disease prior to the introduction of recombinant erythropoietin.1 Despite the introduction of a variety of pharmacological agents and greater awareness of existing and emerging blood-borne diseases, blood transfusions persist as an important therapy to combat anemia and other complications arising in dialysis patients.2

Most investigations of the relationship between transfusion history and hepatitis C status in dialysis populations have relied on self-reported information.3-6 Self-reported exposure data are vulnerable to recall bias, which threatens the internal validity of a study. Retrospective interviews rely heavily on respondents' recall, and often there are no existing records available for validation of the self-reported exposures.7 Factors that may influence accuracy of self-report include: 1) the importance of the exposure(s) to the individual, 2) the way the exposure is defined and its interpretation by the participant, 3) the time frame in which the exposure(s) occurs, 4) the participant's knowledge about the exposure and how precisely it is disclosed to the interviewer and 5) the health of the participant.8,9

The purpose of this analysis was to assess the validity of self-reported transfusion histories in dialysis patients. Using data from a cross-sectional study of a dialysis population being investigated for hepatitis C infection, the correspondence between selfreported transfusion history and transfusion records was explored.

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