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[Validity of the MONICA cardiovascular questionnaire compared with clinical records]
José M Baena-Díez1, María T Alzamora-Sas, María Grau
1Centro de Salud La Marina, Institut Català de la Salut, Barcelona, España. jbaena@imim.es
Insights
The Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) questionnaire accurately assesses cardiovascular disease, risk factors, and treatments in adults over 50. This study validates its use against clinical records, confirming its reliability for epidemiological research.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Cardiovascular diseases (CVD) pose a significant global health burden.
- Accurate data collection on CVD prevalence, risk factors, and treatments is crucial for effective public health strategies.
- The Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) questionnaire is a widely used tool for epidemiological surveillance.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the MONICA questionnaire.
- To compare MONICA questionnaire data with established clinical records for validity assessment.
- To determine the reliability of the MONICA questionnaire in identifying cardiovascular conditions, risk factors, and treatments in individuals over 50 years of age.
Main Methods:
- A prospective, multicenter study involving 3,329 participants aged over 50.
- Simple random sampling was employed across 32 primary health care centers.
- The study assessed diagnoses (acute myocardial infarction, angina pectoris, cerebrovascular disease, hypertension, diabetes mellitus, hypercholesterolemia) and treatments, calculating sensitivity, specificity, predictive values, and kappa index.
Main Results:
- The MONICA questionnaire demonstrated high sensitivity (>90%) and specificity (>90%) for most cardiovascular variables, with slight variations for angina pectoris and cerebrovascular disease.
- Positive predictive values exceeded 80% for major conditions like acute myocardial infarction and hypertension.
- Negative predictive values were consistently above 90%, and kappa indexes generally indicated substantial agreement, except for hypercholesterolemia and diabetes mellitus.
Conclusions:
- The MONICA cardiovascular questionnaire is a valid instrument for assessing cardiovascular disease, its risk factors, and associated treatments.
- The findings support the continued use of the MONICA questionnaire in epidemiological studies and public health surveillance for populations aged over 50.
- The study confirms the MONICA questionnaire's utility in providing reliable data for monitoring CVD trends and determinants.
Objective:
To assess the validity of the questionnaire Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) compared with clinical records.
Methods:
A descriptive, prospective, multicenter study was performed within the framework of the Peripheral Arterial Disease Study (PERART) in 3,329 persons aged >50 years old. The sample was selected by simple random sampling in 32 primary health care centers. The diagnoses included were acute myocardial infarction, angina pectoris, cerebrovascular disease, hypertension, diabetes mellitus, and hypercholesterolemia. Treatment variables were also considered (antihypertensive, lipid-lowering and hypoglycemic agents or insulin, as well as antiplatelet or anticoagulant agents). The sensitivity, specificity, predictive values, and kappa index were computed to test the validity of the MONICA questionnaire.
Results:
The mean age was 65 years (SD 8.9) and 54.8% were women. The sensitivity of the questionnaire was >90% for all the variables apart from angina pectoris (89.9%) and cerebrovascular disease (86.5%). Specificity was also >90%, except for angina pectoris (88.3%) and hypercholesterolemia (77.5%). The positive predictive value was >90% for all the treatments; >80% for angina pectoris, acute myocardial infarction and hypertension; 79.4% for cerebrovascular disease; 79.1% for hypercholesterolemia and 73.4% for diabetes mellitus. The negative predictive value was >90% for all the variables. The kappa indexes were >0.80 for all the variables apart from hypercholesterolemia (0.69) and diabetes mellitus (0.79).
Conclusions:
The MONICA cardiovascular questionnaire is valid in the assessment of cardiovascular disease, risk factors and treatments in patients aged >50 years old.
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