TY  - BOOK
AU  - Howard, Barbara V
TI  - Comparing Vascular Brain Injury and Stroke by Cranial Magnetic Resonance Imaging, Physician-Adjudication, and Self-Report: Data from the Strong Heart Study
SN  - 0251-5350
PY  - 2021///
KW  - *Cerebrovascular Trauma
KW  - *Physicians
KW  - *Stroke
KW  - Cerebrovascular Trauma/dg [Diagnostic Imaging]
KW  - Cerebrovascular Trauma/ep [Epidemiology]
KW  - Humans
KW  - Magnetic Resonance Imaging
KW  - Self Report
KW  - Stroke/dg [Diagnostic Imaging]
KW  - Stroke/ep [Epidemiology]
KW  - MedStar Health Research Institute
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
N2  - BACKGROUND: Epidemiologic studies often use self-report as proxy for clinical history. However, whether self-report correctly identifies prevalence in minority populations with health disparities and poor health-care access is unknown. Furthermore, overlap of clinical vascular events with covert vascular brain injury (VBI), detected by imaging, is largely unexamined; CONCLUSION: In this community-based cohort, self-report for prior stroke had good performance metrics. A majority of participants with VBI did not have overt, clinically recognized events but did have neurological or cognitive symptoms. Data collection methodology for studies in a resource-limited setting must balance practical limitations in costs, accuracy, feasibility, and research goals. Copyright (c) 2021 S. Karger AG, Basel; METHODS: The Strong Heart Study recruited American Indians from 3 regions, with surveillance and adjudication of stroke events from 1989 to 2013. In 2010-2013, all 817 survivors, aged 65-95 years, underwent brain imaging, neurological history interview, and cognitive testing. VBI was defined as imaged infarct or hemorrhage; RESULTS: Adjudicated stroke was prevalent in 4% of participants and separately collected, self-reported stroke in 8%. Imaging-defined VBI was detected in 51% and not associated with any stroke event in 47%. Compared with adjudication, self-report had 76% sensitivity and 95% specificity. Participants with adjudicated or self-reported stroke had the poorest performance on cognitive testing; those with imaging-only (covert) VBI had intermediate performance
UR  - https://dx.doi.org/10.1159/000517804
ER  -