<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>13</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Ingrid Pelgrims</style></author><author><style face="normal" font="default" size="100%">Brecht Devleesschauwer</style></author><author><style face="normal" font="default" size="100%">Kris Doggen</style></author><author><style face="normal" font="default" size="100%">Stefanie Vandevijvere</style></author><author><style face="normal" font="default" size="100%">Eva M De Clercq</style></author><author><style face="normal" font="default" size="100%">S Vansteelandt</style></author><author><style face="normal" font="default" size="100%">Johan Van der Heyden</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Validity of self-reported data to assess the prevalence of overweight, hypertension and cholesterol</style></title><secondary-title><style face="normal" font="default" size="100%">European Journal of Public Health</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2021</style></year><pub-dates><date><style  face="normal" font="default" size="100%">Aug-10-2022</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">31</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;Background&lt;/p&gt;

&lt;p&gt;Accurate data on the risk factors of non-communicable diseases is essential to build evidence-based prevention programs. In Belgium, this is assessed through self-reported (SR) data from the Belgian health interview surveys (BHIS) in a wide population sample or through objective measures from small-scale surveys (such as the Belgian health examination survey [BHES]). It has been shown, however, that relying on SR data leads to a prevalence underestimation. The objective of this study is to assess the agreement between SR and measured overweight, hypertension and high cholesterol and to provide information to do a valid correction for measurement error.&lt;/p&gt;

&lt;p&gt;Methods&lt;/p&gt;

&lt;p&gt;The BHIS/BHES 2018 database was used (n = 1184). Kappa coefficient was used to assess the agreement between SR and measured hypertension (systolic BP &amp;gt; 140 mmHg, diastolic BP &amp;gt; 90 mmHg, or reported use of medication for hypertension) and ICC was used to assess the agreement between SR and measured BMI. SR high cholesterol was compared to a measured total serum cholesterol &amp;gt;190 mg/dl.&lt;/p&gt;

&lt;p&gt;Results&lt;/p&gt;

&lt;p&gt;Risk factor prevalence based on SR data is severely underestimated. The agreement between SR and measured data is high for BMI (ICC: 0.92), moderate for hypertension (Kappa: 0.49) and poor for cholesterol (Kappa: 0.05). Using SR data, 45% of the people with a measured hypertension and 22% of the people with a measured high cholesterol are detected. With regressions based on the SR risk factor, age, sex and education, the measured BMI and hypertension can be predicted with a good accuracy (BMI: R2: 87%, HBP: AUC: 86%). A lower accuracy is observed for the cholesterol model (AUC: 65%). Using predicted values instead of SR data yields higher estimates of people suffering from overweight (+8% relative increase), obesity (+12%), hypertension (+24%) and cholesterol (+36%).&lt;/p&gt;

&lt;p&gt;Conclusions&lt;/p&gt;

&lt;p&gt;Using SR data yields to an underestimation of the prevalence of obesity, hypertension and high cholesterol in Belgium&lt;/p&gt;

&lt;p&gt;Key messages&lt;/p&gt;

&lt;p&gt;Relying on SR data to assess the prevalence of overweight, hypertension and high cholesterol requires a correction for measurement error.&lt;/p&gt;

&lt;p&gt;Using the predicted values from regression models based on the SR risk factor, age, sex and education, yields higher estimates of people suffering from overweight, hypertension and cholesterol.&lt;/p&gt;
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