来自全国健康访谈调查的癌症筛查问题的可靠性
Reliability of cancer screening questions from the National Health Interview Survey.
摘要(中文译文)
美国国家健康访谈调查（NHIS）是一项针对平民非机构化人群的全国性面对面和电话调查，用于衡量癌症筛查方面“健康人民”目标的进展。调查报告已与病历数据进行比对以评估这些问题的有效性；然而，很少有研究评估其可靠性，即随时间推移的回答一致性。我们评估了2021年和2022年NHIS中宫颈癌、结直肠癌、乳腺癌和肺癌筛查问题的重测信度。我们调查了来自美国四个卫生系统（三个位于华盛顿州，一个位于密歇根州）的1,770名18岁及以上成年人，这些成年人有或无乳腺癌、宫颈癌、结直肠癌和肺癌既往筛查史，以检验NHIS问题的有效性。在完成有效性调查的人群中，我们将个体随机分配至一个月后（N=944）和三个月后（N=822）接受额外调查。我们计算了Cohen's Kappa、Gwet's AC1和简单一致性以评估信度。在研究样本中，分配至一个月随访的535人（占分配人数的56.7%）和分配至三个月随访的537人（65.0%）完成了信度调查。其中，分配至一个月和三个月随访的分别有36人（6.6%）和94人（17.6%）被排除在信度分析之外，因为他们在完成有效性调查后接受了额外的筛查检测。Cohen's Kappa显示，乳腺X线摄影筛查处于最新状态的信度为强至中等：一个月时为0.83，三个月时为0.78；其他筛查检测的信度则低得多：宫颈癌分别为0.61和0.60，结直肠癌分别为0.57和0.62，肺癌分别为0.72和0.58（一个月和三个月）。我们发现，在初始调查后一个月和三个月回忆乳腺癌筛查的回答具有强至中等信度。信度可能不是自我报告癌症筛查行为的主要威胁。
Abstract
The National Health Interview Survey (NHIS), a nationwide in-person and telephone survey of the civilian non-institutionalized population, is used to measure progress towards Healthy People objectives on cancer screening. Survey reports have been compared to medical record data to assess validity of these questions; however, few studies have assessed reliability, or response consistency over time. We assessed the test-retest reliability of questions on cervical, colorectal, breast and lung cancer screening from the 2021 and 2022 NHIS. We surveyed 1,770 adults ages 18 + years with and without prior screening for breast, cervical, colorectal, and lung cancer from four U.S. health systems (three in Washington state and one in Michigan) to examine validity of the NHIS questions. Among people who completed the validity survey, we randomized individuals to receive an additional survey one month later (N = 944) and three months later (N = 822). We calculated Cohen's Kappa, Gwet's AC1, and simple concordance to assess reliability. Among our study sample, 535 (56.7% of those assigned) to one month follow-up and 537 (65.0%) assigned to three month follow-up completed the reliability survey. Among these, 36 (6.6%) and 94 (17.6%) of those assigned to one and three month follow-up respectively were excluded from reliability analyses because they had additional screening tests after completing the validity survey. Cohen's Kappa showed strong-to-moderate reliability for being up to date with mammography screening: 0.83 at one month and 0.78 at three months; reliability for other screening tests was considerably lower: 0.61 and 0.60 for cervical, 0.57 and 0.62 for colorectal, and 0.72 and 0.58 for lung and one and three months, respectively. We found strong-to-moderate reliability of responses recalling breast cancer screening at one and three months following an initial survey. Reliability may not be a major threat to self-reported cancer screening behavior.
如何引用
AMA
Larry G Kessler, Bryan Comstock, Erin J Aiello Bowles, Jin Mou, Michael G Nash, Perla Bravo, et al. Reliability of cancer screening questions from the National Health Interview Survey.. PloS one. 2026; doi:10.1371/journal.pone.0352356.
APA
Larry G Kessler, Bryan Comstock, Erin J Aiello Bowles, Jin Mou, Michael G Nash, Perla Bravo, et al (2026). Reliability of cancer screening questions from the National Health Interview Survey.. PloS one. https://doi.org/10.1371/journal.pone.0352356
GB/T 7714
Larry G Kessler, Bryan Comstock, Erin J Aiello Bowles, Jin Mou, Michael G Nash, Perla Bravo, et al. Reliability of cancer screening questions from the National Health Interview Survey.[J]. PloS one, 2026 doi:10.1371/journal.pone.0352356.
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