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Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS)

Authors :
Yuwei Pan
Jitka Pikhartova
Martin Bobak
Hynek Pikhart
Source :
BMC Public Health, Vol 22, Iss 1, Pp 1-11 (2022)
Publication Year :
2022
Publisher :
BMC, 2022.

Abstract

Abstract Background Despite the widespread use of the single item self-rated health (SRH) question, its reliability has never been evaluated in Chinese population. Methods We used data from the China Health and Retirement Longitudinal Study, waves 1–4 (2011–2019). In wave 1, the same SRH question was asked twice, separated by other questions, on a subset of 4533 subjects, allowing us to examine the test–retest reliability of SRH. In addition, two versions of SRH questions (the WHO and US versions) were asked (n = 11,429). Kappa (κ), weighted kappa ( $${\kappa}_{w}$$ κ w ), and polychoric correlation coefficient (ρ) were used for reliability assessment. Cox proportional-hazards models were estimated to assess the predictive validity of SRH measurement for mortality over 7 years of follow up. To do so, relative index of inequality (RII) and slope index of inequality (SII) were estimated for each SRH scale. Results There was moderate to substantial test–retest reliability (κ = 0.54, $${\kappa}_{w}$$ κ w =0.63) of SRH; 31% of respondents who used the same scale twice changed their ratings after answering other questions. There was strong positive association between the two SRH measured by the two scales (ρ > 0.8). Compared with excellent/very good SRH, adjusted hazard ratios (HR) of death are 2.30 (95% CI, 1.70–3.13) for the US version and 1.86 (95% CI, 1.33–2.60) for the WHO version. Using slope indices of inequality, the WHO version estimated slightly larger mortality differences (RII = 3.50, SII = 15.53) than the US version (RII = 3.25, SII = 14.80). Conclusions In Chinese middle-aged and older population, the reliability of SRH is generally good, although the two commonly used versions of SRH scales could not be compared directly. Both indices predict mortality, with similar predictive validity.

Details

Language :
English
ISSN :
14712458
Volume :
22
Issue :
1
Database :
Directory of Open Access Journals
Journal :
BMC Public Health
Publication Type :
Academic Journal
Accession number :
edsdoj.70d734c72da440be88be9e6cb069090e
Document Type :
article
Full Text :
https://doi.org/10.1186/s12889-022-14218-1