Evidence map›Paper›PMID 42576717›Full record

ArticleJournal of Korean medical science2026

Validation of Self-Reported Disease History in Korea: A National Health Insurance Cohort Study.

Yeon Woo Oh, Eun-Cheol Park

Abstract readValidation Study
In one paragraph

Article in Journal of Korean medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

2 authors.

Yeon Woo OhDepartment of Biostatistics and Computing, Yonsei University Graduate School, Seoul, Korea.ORCID https://orcid.org/0009-0002-2485-1400
Eun-Cheol ParkDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-2306-5398

Funding

Korea Medical Institute
6 · The paper itself

Abstract

backgroundSelf-reported disease history is widely used in epidemiological studies but is susceptible to misclassification. This study aimed to evaluate the accuracy of self-reported history of hypertension, diabetes, dyslipidemia, and stroke in Korea and to identify factors associated with reporting accuracy.

methodsWe analyzed data from the National Health Insurance Service (NHIS)-National Sample Cohort (2002-2019) for participants aged ≥ 40 years who underwent health check-ups (n = 312,367 for hypertension, 291,356 for diabetes, 289,596 for dyslipidemia, and 278,296 for stroke). Self-reported disease history was compared with medical claims records, which served as the reference standard for diagnosis history. Sensitivity, specificity, positive predictive value, negative predictive value, and observed agreement were calculated. Logistic regression models identified factors associated with false negative responses.

resultsSelf-reported prevalence was substantially lower than claims-based prevalence across all conditions: hypertension (33.9% vs. 47.9%), diabetes (15.0% vs. 36.1%), dyslipidemia (14.7% vs. 66.8%), and stroke (2.0% vs. 7.7%). Sensitivity was highest for hypertension (69.9%), followed by diabetes (40.7%), dyslipidemia (21.6%), and stroke (21.8%). Specificities exceeded 99% for all conditions. Factors reflecting greater healthcare engagement-advanced age and higher comorbidity burden-were associated with better reporting accuracy. Longer duration since initial diagnosis improved sensitivity for chronic conditions, while longer time since last hospital visit decreased sensitivity for hypertension and dyslipidemia.

conclusionSelf-reported disease history in the NHIS health check-up demonstrates high specificity but variable sensitivity across conditions, with underreporting being the primary concern. Temporal factors and healthcare engagement patterns significantly influence reporting accuracy. Our disease-specific validation parameters provide essential benchmarks for bias correction in epidemiological research and clinical practice in Korea, particularly for conditions with lower reporting sensitivities.

Indexed as

Diabetes MellitusDyslipidemiasHypertensionSelf ReportStrokeAdultAgedCohort StudiesFemaleHumansLogistic ModelsMaleMiddle AgedNational Health ProgramsPrevalenceRepublic of KoreaKoreaMedical History TakingNational Health Insurance ServiceSelf ReportValidation Study

Identifiers

PMID42576717
PMCPMC13457785

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