Original ArticlesPatients' sibling history was sensitive for hypertension and specific for diabetes
Introduction
Family history plays an important role in the prevention and clinical management of common chronic diseases [1]. Major modifiable cardiovascular risk factors, such as hypertension and diabetes, result from the complex interaction of several genetic and environmental factors and show familial aggregation [2]. By its ability to capture genetic information and gene–environment interactions, family history is a useful tool to predict the risk of future cardiovascular disease within family members [3]. An African study [4] found, for example, that individuals with a positive family history of hypertension had higher blood pressure, and those with a positive family history of diabetes had higher blood glucose. A case–control study conducted in South Africa observed a fourfold increased risk of diabetes in patients with a positive family history of diabetes [5].
Assessing the analytic validity of the family history is a key element in the evaluation of family history as a screening tool [6]. The analytic validity, that is, the sensitivity and specificity, indicates how accurately and reliably the family history can identify a particular disease in a family member of a respondent. Few studies have evaluated the analytic validity of the family history of diabetes [6], [7], [8] and hypertension [7], [8], [9]. Among them, only one has validated the relatives' disease status for hypertension [9].
In this report, we examined the analytic validity of reported family history of hypertension and diabetes mellitus among siblings in a middle income African country. All participants had their disease status validated through clinical measurement.
Section snippets
Population and methods
The study took place in the Republic of Seychelles, Indian Ocean, a middle-income country with a high prevalence of hypertension, diabetes, and other risk factors [10], [11], [12], [13]. Health care is delivered through a national health system, and medical care and treatment are free of charge to all inhabitants. More than 80% of adults seek primary health care at least once per year, and the basic knowledge on hypertension is fairly good among the adult population [14]. We used data from an
Results
Among the 404 participating siblings from 73 families, personal history data were available in 384 siblings for hypertension and in 404 for diabetes. The number of siblings per family varied from 2 to 11 with a median of 8. Information about the siblings' hypertension and diabetes were obtained for 1,588 respondent-sibling pairs. We excluded 122 pairs for hypertension and 13 pairs for diabetes because the personal disease status was unknown or the response missing, leaving respectively 1,466
Discussion
The analytic validity of the sibling history to identify hypertension and diabetes among siblings was assessed using two gold standards, the personal history provided by the sibling and the clinical status of the sibling. Although the sibling's clinical status reflects the sibling's actual cardiovascular risk, the sibling's personal history provides the best possible information that a respondent, when asked about a sibling's disease status, can be expected to know. Information on personal
Acknowledgements
The authors thank Dr Laurent Schild (Faculty of medicine of Lausanne) for helpful comments. The study benefited from a grant from the Swiss National Science Foundation (TANDEM No 31-51115.97).
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Cited by (8)
Put the Family Back in Family Health History: A Multiple-Informant Approach
2017, American Journal of Preventive MedicineCitation Excerpt :Accordingly, many advocate using FHH for preventing complex diseases such as heart disease and Type 2 diabetes mellitus (T2DM).5–7 In clinical practice, FHH is routinely collected but underutilized, owing in part to inaccuracy in self-reports.8–12 When validated with medical records, accuracy of individuals’ reports of parental history is 74% for heart disease, about 60% for T2DM, about 50% for hypertension, and less than 20% for high cholesterol.11
Accuracy of self-reported family history is strongly influenced by the accuracy of self-reported personal health status of relatives
2012, Journal of Clinical EpidemiologyCitation Excerpt :In other words, family history reporting is more accurate when relatives have correct knowledge about their own personal health status. Bochud et al. [14] reported a smaller improvement in sensitivity for diabetes but no improvement for hypertension. In their study, the sensitivity for hypertension was already very high (89.0%), likely because all subjects were relatives of patients who participated in a hypertension study.
A Bayesian hierarchical logistic regression model of multiple informant family health histories
2019, BMC Medical Research Methodology