Abstract Background
Self-reported
hypertension is a useful
method to estimate
prevalence in the
population. However, it is necessary to evaluate its accuracy, in relation to the
gold-standard diagnostic
methods of the
disease. Objectives To estimate combined
measures of
sensitivity and specificity for
self-reported
hypertension, using Brazilian
validation studies that included
gold standard
methods.
Methods A
systematic review and a
meta-analysis were developed. Two independent examiners evaluated 1389 and read 113 potentially eligible articles. Since
self-reported
morbidity is influenced by the cultural and economic characteristics of a
population, as well as by its accessibility to
medical care, only studies from one country (
Brazil) were included. First, a
qualitative analysis was performed, evaluating the relationship between
self-reported
hypertension and its measurement through
gold-standard
methods. Subsequently, a
meta-analysis estimated the combined
sensitivity and specificity for the included studies. Due to a high heterogeneity among studies, the
meta-analysis used a random effects model.
Bias risks were evaluated by the QUADAS-2 protocol and the standard significance level of 10% was used in all modelling. Results Five studies were included in the
qualitative analysis; and four had the necessary information for inclusion in the
meta-analysis.
Patient selection and Index Test (the question allowing for
self-
reporting) were the domains with the highest
risk of
bias. In the
meta-analysis, combined
sensitivity and specificity were 77%(95%CI[74.5-79.0%]) and 88%(95%CI[86.3-88.6%]), respectively. Conclusions The analysed studies allowed for the estimation of more reliable values for combined
sensitivity and specificity. These values were higher than those usually found in studies with greater
population heterogeneity.