Introduction
Methods
Search methods for identification of studies
In the search on “work-related ill health,” we used the terms “Occupational Diseases”[Mesh], “Occupational Health”[Mesh], work-related ill health, work-related illness, work-related disease(s), work-related disorders, work-related complaints, work-related symptoms |
In the search on “self-report,” we used the terms “Self Assessment (Psychology)”[Mesh], self evaluation, self-report, self-reporting, self-reported, self assessment, self-assessed, self-administrated, self-administration |
In the search on self-report measures, we used the terms “Questionnaires”[Mesh], “Weights and Measures/methods”[Mesh], “Interviews as Topic” [Mesh], scale(s), test(s), measure(s), measurement(s), method(s) |
To answer the second research questions, one search was built after exploring the concepts of work-related ill health, self-report, validity/reliability |
In the search on validity and reliability, we used the terms “Psychometrics”[Mesh], “Reproducibility of Results”[Mesh], valid, validity, reliable, reliability, compare, comparison, agree, agreement, repeatable, repeatability, test–retest, consistent, consistency |
Inclusion criteria
Types of studies
Participants
-
working adults or adolescents (>16 year), or
-
workers presenting their work-related health problems in occupational health care (e.g., consulting an occupational health clinic or visiting an occupational physician or other health care worker specialized in occupational health), or
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workers presenting their as such identified work-related health problems in general health care (e.g., visiting a general practitioner or medical specialist not specialized in occupational health).
Index tests and target conditions
Reference standards
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Clinical examination by a physician, physiotherapist, or registered nurse resulting in either a specific diagnosis or recorded clinical findings;
-
Physician’s diagnosis based on clinical examination combined with results from function(al) tests (e.g., in musculoskeletal disorders) or clinical tests (e.g., spirometry);
-
Results of function or clinical tests (e.g., audiometry, spirometry, blood tests, specific function tests).
Data collection and analysis
Selection of articles
Data extraction
Assessment of method quality
1 | Aim of the study | Evaluation of validity of self-report was clearly stated as one of the aims of the study | 3 | Main aim |
2 | Part of study or secondary analysis | |||
1 | Addressed in small part of study | |||
0 | No aim or not clearly stated | |||
2 | Sampling | The sampling frame and sampling procedures were clearly stated | 3 | All 3 items OK |
2 | 2 items OK | |||
Inclusion and exclusion criteria were clear | 1 | 1 item OK | ||
Able to account for all of the participants at each stage of the study | 0 | None OK | ||
3 | Sample size | The study was well powered; studies fell into four sizes according to their likelihood of good statistical power | 3 | >600 |
2 | 300–600 | |||
1 | 100–300 | |||
0 | <100 | |||
4 | Response rate | The response rate was satisfying | 3 | >85% |
2 | 70–85% | |||
1 | 50–69% | |||
0 | <50 | |||
5 | Design | The design was a | 3 | Prospective cohort or cross-sectional with controls |
2 | Case–control | |||
1 | Cohort or cross-sectional without controls | |||
0 | Not clearly designed | |||
6 | Timeline | Self-report before examination/testing | 1 | Yes |
0 | No | |||
7 | Interval | The interval between self-report and examination was clear and not too long to introduce significant changes in health status | 3 | Self-report immediately (same day) before examination/testing |
2 | Self-report within 6 w before examination/testing | |||
1 | Report before examination/testing without interval stated or interval > 6 w | |||
0 | Examination/testing before self-report | |||
8 | Blinding of examiner | Was the examining professional aware of the outcomes of self-report | 1 | Examiner was blinded to self-report |
0 | Examiner was not blinded to self-report or blinding not stated | |||
9 | Outcome assessment | Case definitions for self-report and outcome of examination/testing were explicit and relevant, and the study referred to assessment criteria to suggest it was repeatable. | 3 | Clear case definitions for participant and examiner and explicit stated criteria |
2 | Clear case definitions without criteria stated | |||
1 | Minimal case definitions | |||
0 | Or no criteria stated |
Data analysis and synthesis
Author, year | Health condition | Reference standard | Kappa values | % or correlation | Agreement | |
---|---|---|---|---|---|---|
1 | Mehlum et al. (2009) | MSD upper limbs | CE | 0.16–0.34 | – | Low |
2 | Descatha et al. (2007) RtS | MSD upper limbs | CE | 0.45–0.77 | – | Moderate–high |
3 | Descatha et al. (2007) PdLS | MSD upper limbs | CE | 0.22–0.45 | – | Low–moderate |
4 | Perreault et al. (2008) | MSD upper limbs | CE | 0.44 | 72 | Moderate |
5 | Kaergaard et al. (2000) | MSD upper limbs | CE | – | 0.54–0.62 | Moderate |
6 | Silverstein et al. (1997) | MSD | CE | 0.23–0.47 | – | Low–moderate |
7 | Svensson et al. (2002) | Hand eczema | CE | 0.47–0.65 | – | Moderate–high |
8 | Zetterberg et al. (1997) | MSD | CE + Tests | – | Sign. corr. | Not assessable |
9 | Toomingas et al. (1995) | MSD upper limbs | CE + Tests | <0.20 | – | Low |
10 | Gomez et al. (2001) | Hearing loss | Tests | 0.55 | 80 | Moderate–high |
11 | Lundström et al. (2008) | Neurological symptoms | Tests | – | 58–60 | Low |
12 | Dasgupta et al. (2007) | Pesticide poisoning | Tests | – | ≤0.17 | Low |
13 | Kauffmann et al. (1997) | Respiratory disorders | Tests | – | Sign. corr. | Not assessable |
Author, year | Self-report | Reference standard | Sensitivity | Specificity | |
---|---|---|---|---|---|
1 | Åkesson et al. (1999) | MSD symptoms | Clinical findings | 0.45–0.73 | 0.81–0.97 |
Diagnoses | 0.67–0.89 | 0.55–0.89 | |||
2 | Bjorksten et al. (1999) | MSD symptoms | Diagnoses | 0.71–1.00 | 0.21–0.66 |
3 | Kaergaard et al. (2000) | MSD symptoms | Diagnoses (Myofascial pain syndrome) | 0.67–1.00 | 0.68–0.74 |
Diagnoses (Rotator cuff syndrome) | 0.69–0.78 | 0.79–0.84 | |||
4 | Silverstein et al. (1997) | MSD symptoms | Clinical findings | 0.77–0.88 | 0.21–0.38 |
5 | Toomingas et al. (1995) | MSD findings | Clinical findings | 0–1.00 | 0.63–0.99 |
6 | Bolen et al. (2007) | Lung; work-related asthma exacerbation | Tests (PEF) results | 0.15–0.62 | 0.65–0.89 |
7 | Johnson et al. (2009) | Lung symptoms | Diagnoses | 0.33–0.89 | 0.39–0.88 |
8 | Nettis et al. (2003) | Latex allergy symptoms | Diagnoses | 0–1.00 | 0.72–0.88 |
Author, year | Self-reported work relatedness | Work relatedness in reference standard | Outcomes on work relatedness | |
---|---|---|---|---|
1 | Mehlum et al. (2009) | Yes, musculoskeletal disorders of neck or upper extremities | Physician assessed | Positive specific agreement 76–85% |
Negative specific agreement 37–51% | ||||
2 | Bolen et al. (2007) | Yes, work-exacerbated asthma | Test results | Agreement on 33% |
3 | Lundström et al. (2008) | Yes, vibration-related symptoms | Test results | Agreement on 58–60% |
4 | Dasgupta et al. (2007) | Yes, pesticide exposure-related symptoms | Test results | Correlation symptoms with test results: ≤0.17 |
5 | Livesley et al. (2002) | Yes, hand dermatitis symptoms | Physician assessed | Sensitivity = 0.68, Specificity = 1.00 |
6 | Kujala et al. (1997) | No, glove use-related skin symptoms | Physician + tests | Sensitivity = 0.84, Specificity = 0.98 when combining 1–3 skin with 2–3 mucosal symptoms |
7 | Nettis et al. (2003) | No, glove use-related skin and lung symptoms | Physician + tests | Predictive value for symptoms low, except for “localized contact urticaria” |
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For studies that reported an assessment of concordance (e.g., kappa for categorical variables or Pearson correlation coefficients for continuous variables), the reported statistic was categorized according to the following criteria:
-
Kappa values >0.6 were considered high, results between 0.6 and 0.4 were considered moderate, and kappa values <0.4 were considered low (Landis and Koch 1977)
-
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To assess sensitivity (SE), specificity (SP) independently for each measure, a value of >85% was considered high, 70–85% was considered moderate, and <70% was considered low.
Investigation of heterogeneity
Results
Search results
Methodological quality of included studies
Characteristics of included studies
Reference | Self-report measure | WR | Reference standard | Population description and number of participants | Study quality | |
---|---|---|---|---|---|---|
Musculoskeletal disorders
| ||||||
1 | Åkesson et al. (1999) | NMQ 7 d/12 mo; | No | Examination on the same day measuring clinical findings and diagnoses | Sweden: 90 female dental personnel and 30 controls (medical nurses) | 20, High |
Present pain ratings on scale | ||||||
2 | Bjorksten et al. (1999) | NMQ-Modified; | No | Examination on the same day by physiotherapist following a structured schedule | Sweden: 171 unskilled female workers in monotonous work in metal-working or food-processing industry | 16, High |
Current pain rating on VAS scale; | ||||||
Body map pain drawings | ||||||
3 | Descatha et al. (2007) RtS | NMQ-Upper Extremities | No | Standardized clinical examination. Positive if (1) diagnosis “proved” during clinical examination, (2) diagnosis “proved” before clinical examination (e.g., previous diagnosis by a specialist, and (3) suspected diagnosis (not all of the criteria were met in clinical examination) | France: “Repetitive task” survey (RtS) 1,757 workers in 1993–1994 and 598 workers in 1996–1997 | 17, High |
4 | Descatha et al. (2007) PdLS | NMQ-Upper Extremities | No | Standardized clinical examination, using an international protocol for the evaluation of work-related upper-limb musculoskeletal disorders (SALTSA) | “Pays de Loire” survey (PdLS) 2,685 workers in 2002–2003. | 17, High |
5 | Juul-Kristensen et al. (2006) | NMQ-Upper Extremities-Modified | No | Physiotherapist and physician performed the clinical examination and five physical function tests, all according to a standardized protocol | Denmark: 101 female computer users (42 cases, 61 controls) | 16, High |
6 | Kaergaard et al. (2000) | PRIM, musculoskeletal symptoms (pain, discomfort) in eight body regions | No | Examined at baseline and follow-up by 3 trained physicians using clear case definitions | Denmark: 243 female sewing machine operators: 240 at baseline; 155 at 1-year follow-up | 18, High |
7 | Mehlum et al. (2009) | Researcher Designed questionnaire on musculoskeletal symptoms Upper Extremities “Have you experienced pain in neck or shoulder and pain in elbow, forearm, or hand in the last month, and is this totally or partially caused by working conditions in your present or previous job?” |
Yes
| Occupational physicians performed clinical examination, reporting clinical findings and diagnoses. The work relatedness was assessed using the “Criteria Document for Evaluating the Work relatedness of Upper-Extremity Musculoskeletal Disorders” (SALTSA) | Norway: 217 employees in Oslo Health Study; 177 cases with self-reported work-related pain, 40 controls with self-reported non-work-related pain | 17, High |
8 | Ohlsson et al. (1994) | NMQ-Upper Extremities 7d/12 mo | No | Clinical findings recorded by one examiner (blinded to the answers in the self-report questionnaire), according to a standard protocol and criteria | Sweden: 165 women in either repetitive industrial work (101) or mobile and varied work (64) | 11, Low |
9 | Perreault et al. (2008) | Researcher Designed questionnaire | No | Physical examination was performed according to a standard protocol | France: 187 university workers (80% computer clerical workers, 11% professionals, 7% technicians), 83% female | 13, Moderate |
10 | Silverstein et al. (1997) | Researcher designed questionnaire | No | Clinical examination | USA: Employees of automotive plants (metal, service and engine plants); 713 baseline questionnaire; 626 baseline clinical examination, 579 follow-up clinical examination (416 in both); 357 questionnaire and clinical examination at baseline | 15, Moderate |
Body maps | ||||||
Questions from NMQ | ||||||
11 | Stål et al. (1997) | NMQ-Upper Extremities | No | Clinical examination after twelve months by a physiotherapist, blinded to the results of the questionnaire and according to a standardized protocol and criteria | Sweden: 80 female milkers (active) | 18, High |
12 | Toomingas et al. (1995) | Researcher Designed self-administered examination | No | Clinical examination by one of eight physicians blinded to the symptoms and results of self-examination and according to a strict protocol | Sweden: 350 participants: 79 furniture movers, 89 medical secretaries, 92 men and 90 women from a sample population | 17, High |
13 | Zetterberg et al. (1997) | Researcher Designed questionnaire (~NMQ) | No | Physical examination of neck, shoulder, arm, hand performed according to a protocol by the same orthopedic specialist blinded to the results of the questionnaire; specialists are reporting clinical findings | Sweden: 165 women in either repetitive industrial (101) or mobile and varied work (64) | 15, Moderate |
Skin
| ||||||
14 | Cvetkovski et al. (2005) | Researcher Designed questionnaire on the severity of the eczema | No | Clinical assessment by specialized dermatologist from the Danish National Board of Industrial Injuries (DNBII) registry, using the DNBII severity assessment | Denmark: 602 patients with work-related hand eczema | 18, High |
15 | De Joode et al. (2007) | Symptom Based Questionnaire Picture Based Questionnaire | No | Clinical examination by one of two dermatologists | Netherlands: 80 SMWF (semi-synthetic metal-working fluids)-exposed metal workers and 67 unexposed assembly workers | 15, Moderate |
16 | Livesley et al. (2002) | Researcher Designed questionnaire |
Yes
| Clinical examination by an experienced dermatologist who decided whether the skin problem was work-related based on clinical diagnosis, test results and exposure at work | UK: 105 workers in the printing industry; 45 with and 60 workers without a self-reported skin problem | 13, Moderate |
17 | Meding and Barregard (2001) | Researcher Designed, single question: Have you had hand eczema on any occasion during the past twelve months? | No | Diagnosis of hand eczema through common clinical practice of combined information on present and past symptoms, morphology and site of skin symptoms and course of disease | Sweden: workers with vs. without self-reported hand eczema: 105 vs. 40 car mechanics, 158 vs. 92 dentists and 10 vs. 64 office workers | 12, Moderate |
18 | Smit et al. (1992) | Symptom Based Questionnaire | No | Medical examination by a dermatologist within days or weeks after questionnaire using clear case definitions | Netherlands: 109 female nurses | 15, Moderate |
Self-diagnosis of hand dermatitis | ||||||
19 | Susitaival et al. (1995) | Self-diagnosis single question: “Do you have a skin disease now?” | No | Clinical examination with a dermatologist. immediately after answering questionnaire | Finland: farmers, 41 with and 122 without dermatitis | 12, Moderate |
20 | Svensson et al. (2002) | Symptom Based Questionnaire Self-diagnosis single question: “Do you have hand eczema at the moment?” | No | Dermatologist examined their hands immediately after that without knowing the participants’ answers | Sweden: 95 patients referred for hand eczema; 113 workers (40 dentists, 73 office workers) | 18, High |
21 | Vermeulen et al. (2000) | Symptom Based Questionnaire | No | Medical evaluation by 1 of 2 dermatologists in same week. Case definitions of medically confirmed hand dermatitis (major/minor) clearly stated | Netherlands: 202 employees in the rubber manufacturing industry | 15, Moderate |
Respiratory disorders
| ||||||
22 | Bolen et al. (2007) | Measures of self-reported work aggravated asthma: |
Yes
| Serial peak expiratory flow (PEF) testing | USA: 95 out of 382 (25%) workers enrolled in a health plan (Health Maintenance Organisation); from 382 invited, 178 had spirometry (47%), and 138 (36%) did > 2 w PEF (peak expiratory flow) testing | 10, Low |
Daily log on symptoms and medication use | ||||||
Post-test telephone survey on symptoms and medication use | ||||||
23 | Demers et al. (1990) | Researcher Designed questionnaire on respiratory symptoms | No | Clinical examination with X-ray and pulmonary function testing | USA: 923 construction workers (union members; boilermakers, pipefitters; 71% working, 70% response) | 15, Moderate |
24 | Johnson et al. (2009) | Farm Health Interview Survey on lung symptoms through Telephone survey | No | Physical examination and spirometry by an occupational physician or an advanced practice registered nurse | USA: 160 farmers, working; 134 farmers completed spirometry | 12, Low |
25 | Kauffmann et al. (1997) | Single question: “Do you think that your bronchial or respiratory status has changed (over 12 yr)? Feels worse/better?” | No | Pulmonary function test, difference in forced expiratory volume in one second (FEV1) over 12 years | France: 915 workers in metallurgy, chemistry, printing and flour milling | 17, High |
Latex allergy
| ||||||
26 | Kujala et al. (1997) | Researcher Designed questionnaire on glove-related symptoms |
Yes
| Clinical examination to establish the diagnosis of occupational latex allergy including positive skin prick tests or a challenge test in an occupational clinic | Finland: 32 out of 37 patients diagnosed with latex allergy; 51 out of 74 controls sampled from hospital staff, matched for age and occupation, all females | 12, Moderate |
27 | Nettis et al. (2003) | Researcher Designed interview on rubber glove-use symptoms |
Yes
| Clinical examination to establish the diagnosis of occupational latex allergy including IgE and skin prick tests | Italy: 61 out of 97 (63%) hairdressers with latex glove-related skin and/or respiratory symptoms | 12, Moderate |
Hearing problems
| ||||||
28 | Choi et al. (2005) | Set of screening questions | No | Pure tone audiometry | USA: 98 male farmers | 11, Low |
RSEE | ||||||
HEW-EHAS | ||||||
29 | Gomez et al. (2001) | Hearing loss questionnaire (Telephone Survey) Self-rating scale | No | Pure tone audiometry | USA: 376 farmers | 15, Moderate |
Miscellaneous
| ||||||
30 | Eskelinen et al. (1991) | Researcher Designed questionnaire | No | Clinical examination: cardio respiratory or musculoskeletal evaluation | Finland: 174 municipal employees: healthy (43 men, 39 women); 46 men with coronary artery disease; 46 women with lower back pain | 15, Moderate |
31 | Lundström et al. (2008) | Stockholm Workshop scale for grading of sensorineural disorders |
Yes
| Vibrotactile perception test and the Purdue Pegboard test, referred to as “quantitative sensory testing” | Sweden: 126 graduates from vocational schools: auto mechanic, construction and restaurant | 11, Low |
32 | Dasgupta et al. (2007) | Researcher Designed questionnaires among others on self-reported pesticide poisoning symptoms |
Yes
| Blood tests measuring acetylcholinesterase enzyme | Vietnam: 190 rice farmers | 14, Moderate |
Findings
Reference | Health status | Type of self-report | Predictive values | Agreement | Remarks | |
---|---|---|---|---|---|---|
1 | Descatha et al. (2007) | MSD Upper Extremities | Symptoms | Complete analysis including all disorders at examination 1993–1994 (1757) | Complete analysis | Prevalence based on self-report > prevalence based on clinical examination |
1993–1994 k = 0.77 (95% CI 0.74–0.80) | ||||||
Repetitive task Survey (RtS) | ||||||
1996–1997 k = 0.57 (95% CI 0.50–0.64) | ||||||
SE = 0.94 [0.93, 0.95]; SP = 0.81 [0.78, 0.84]; PPV = 0.91; NPV = 0.88 | ||||||
Agreement moderate to high | ||||||
Complete analysis including all disorders at examination 1995–1996 (598) | ||||||
SE = 0.82 [0.78, 0.86]; SP = 0.78 [0.71, 0.84]; PPV = 0.90; NPV = 0.64 | ||||||
Sensitivity moderate to high, specificity moderate, | ||||||
PPV high, NPV low to moderate | ||||||
Restrictive analysis with six disorders included 1993–1994 (1757) | Restrictive analysis | |||||
1993–1994 k = 0.52 (95% CI 0.48–0.55) | ||||||
1995–1996 k = 0.45 | ||||||
SE = 0.97 [0.95, 0.98]; SP = 0.57 [0.53, 0.60]; PPV = 0.66; NPV = 0.95 | (95% CI 0.38–0.52) Agreement moderate to high | |||||
Restrictive analysis with six disorders included 1995–1996 (598) | ||||||
SE = 0.87 [0.82, 0.90]; SP = 0.58 [0.52, 0.64]; PPV = 0.68; NPV = 0.80 | ||||||
Sensitivity high, specificity low, PPV low, NPV high | ||||||
2 | Descatha et al. (2007) | MSD Upper Extremities | Symptoms | Extensive (including symptoms about last week and last year) | Extensive | Prevalence based on self-report > prevalence based on clinical examination |
Standard NMQ: k = 0.22 (95% CI 0.19–0.23) Agreement low | ||||||
Pays de Loire Survey (PdLS) | ||||||
Standard quest. SE = 0.83 [0.79, 0.87]; SP = 0.81 [0.79, 0.83] | ||||||
Sensitivity moderate, specificity moderate | ||||||
Restrictive (pain scale rating (PS) and symptoms during examination) | Restrictive | |||||
NMQ, GS > 0: k = 0.44 (95% CI 0.40–0.48) | ||||||
NMQ, GS > 0: SE = 0.82 [0.78, 0.86]; SP = 0.82 [0.81, 0.84] | NMQ, GS ≥ 2: k = 0.45 (95% CI 0.41–0.49) Agreement moderate | |||||
NMQ, GS ≥ 2; SE = 1.00 [0.99, 1.00]; SP = 0.51 [0.49, 0.53] | ||||||
Sensitivity moderate to high, specificity low to moderate | ||||||
3 | Juul-Kristensen et al. (2006) | MSD Upper Extremities | Symptoms | SE = 0.86 [0.68, 0.96]; SP = 0.77 [0.66, 0.86] | – | |
Sensitivity high, specificity moderate | ||||||
4 | Ohlsson et al. (1994) | MSD Upper extremities | Symptoms | All regions combined, related to diagnoses | – | Higher sensitivity related to diagnoses, higher specificity related to clinical findings |
SE = 0.83 [0.72, 0.90]; SP = 0.64 [0.54, 0.74] | ||||||
All regions combined, related to clinical findings | ||||||
SE = 0.66 [0.57, 0.74]; SP = 0.92 [0.74, 0.99] | ||||||
Sensitivity moderate to high, specificity low to moderate | ||||||
5 | Perreault et al. (2008) | MSD Upper Extremities | Symptoms | SE = 0.66 [0.56, 0.75]; SP = 0.79 [0.69, 0.87] | Agreement self-report to physicians assessment 72%; k = 0.44 (95% CI 0.31–0.56): moderate | |
Sensitivity low, specificity moderate | ||||||
Variable agreement when using different case definitions (symptoms, limitations ADL, limitations work, limitations leisure): k = 0.19–0.54 | ||||||
6 | Stål et al. (1997) | MSD Upper Extremities | Symptoms | All regions combined: SE = 0.57 [0.42, 0.71]; SP = 0.72 [0.53, 0.87] sensitivity low; specificity moderate | – | Higher sensitivity related to diagnoses, higher specificity related to clinical findings |
For separate regions variable sensitivity and specificity for either clinical findings (SE = 52–60%, SP = 86–98%), or diagnoses (SE = 59–69%; SP = 72–90%) | ||||||
7 | De Joode et al. (2007) | Hand eczema | Symptoms Self-diagnosis | Symptoms Based Questionnaire (SBQ) | – | Prevalence with SBQ 2.39 times and with PBQ 2.25 times higher than reference standard prevalence |
SE = 0.83 [0.61, 0.95]; SP = 0.64 [0.43, 0.82] | ||||||
Self-diagnosis, with picture based questionnaire (PBQ) | ||||||
SE = 0.36 [0.17, 0.59]; SP = 0.84 [0.64, 0.95] | ||||||
Sensitivity low to moderate, specificity low to moderate | ||||||
8 | Livesley et al. (2002) | Hand eczema | Symptoms | SE = 0.68 [0.56, 0.79]; SP = 1.00 [0.91, 1.00] |
–
| – |
Sensitivity low, specificity high | ||||||
9 | Meding and Barregard (2001) | Hand eczema | Self-diagnosis | All participants combined | – | 1-year PR 14.8–15.0% |
SE = 0.58 [0.50, 0.66]; SP = 0.96 [0.94, 0.97] | Estimated true prevalence 30–60% higher than SR prevalence. | |||||
Sensitivity low, specificity high | ||||||
10 | Smit et al. (1992) | Hand eczema | Symptoms Self-diagnosis | Symptom Based Questionnaire (SBQ) | – | Self-report prevalence based on SBQ 47.7%, on Self-diagnosis 19.4%, and on reference standard 18.3% |
SE = 1.00 [0.83, 1.00]; SP = 0.64 [0.53, 0.74] | ||||||
Sensitivity high, specificity low | ||||||
Self-diagnosis SE = 0.65 [0.41, 0.85]; SP = 0.93 [0.86, 0.97] | ||||||
Sensitivity low, specificity high | ||||||
11 | Susitaival et al. (1995) | Hand eczema | Self-diagnosis | Self-diagnosis | – | Self-report prevalence: 17.1% in men and 22.8% in women, reference standard prevalence 4.1% in men, 14.1% in women |
SE = 0.60 [0.48, 0.72]; SP = 1.00 [0.96, 1.00] | ||||||
Sensitivity low, specificity high | ||||||
12 | Svensson et al. (2002) | Hand eczema | Symptoms Self-diagnosis | Symptoms Based Questionnaire | Papules: k = 0.47 (0.32–0.62) | – |
SE = 0.62 [0.52, 0.72]; SP = 0.87 [0.79, 0.92] | Erythema: k = 0.53 (0.41–0.65) | |||||
Sensitivity low, specificity high | Vesicles: k = 0.55 (0.41–0.69) | |||||
Self-diagnosis SE = 0.87 [0.78, 0.93]; SP = 0.79 [0.70, 0.86] | Scaling: k = 0.55 (0.44–0.66) | |||||
Fissures: k = 0.65 (0.55–0.75) | ||||||
Sensitivity high, specificity moderate | ||||||
13 | Vermeulen et al. (2000) | Hand eczema | Symptoms | ≥1 symptom, recurrent or lasted more than 3 weeks |
–
| Moderate sensitivity and specificity depending on case definition of positive case |
SE = 0.46 [0.34, 0.58]; SP = 0.83 [0.75, 0.89] | ||||||
≥12 symptoms, recurrent or lasted more than 3 weeks | ||||||
SE = 0.63 [0.50, 0.74]; SP = 0.75 [0.67, 0.82] | ||||||
≥1 symptom SE = 0.23 [0.14, 0.34]; SP = 0.89 [0.83, 0.94] | ||||||
Symptoms at examination | ||||||
SE = 0.21 [0.13, 0.33]; SP = 0.85 [0.78, 0.90] | ||||||
14 | Demers et al. (1990) | Respiratory disorders | Symptoms | SE = 0.99 [0.97, 1.00]; SP = 0.99 [0.98, 1.00] Sensitivity high, specificity high |
–
| – |
15 | Kujala et al. (1997) | Latex allergy | Symptoms | Combining 1–3 skin with 1–3 mucosal symptoms: SE = 0.84 [0.67, 0.95]; SP = 0.98 [0.90, 1.00] Sensitivity moderate, specificity high |
–
| – |
16 | Choi et al. (2005) | Hearing loss | Symptoms Self-diagnosis Severity rating | Self-reported screening questions: SE = 0.73 [0.60, 0.84] moderate; SP = 0.81 [0.69, 0.90] moderate |
–
| SE higher in younger age groups, SP higher in older age groups. |
Self-diagnosis (Rating Scale for Each Ear, RSEE): | ||||||
SE = 0.66 [0.52, 0.78] low; SP = 0.84 [0.73, 0.93] moderate | ||||||
Self-rating of severity (HEW-EHAS): | ||||||
SE = 0.54 [0.40, 0.67] low; SP = 0.85 [0.72, 0.93] high | ||||||
17 | Gomez et al. (2001) | Hearing loss | Symptoms | Hearing loss symptoms compared with audiometry (binaural mid-frequency) SE = 0.77 [0.68, 0.85]; SP = 0.82 [0.77, 0.86] | Hearing loss symptoms compared with audiometry (binaural mid-frequency): overall agreement 80%, k = 0.55 | Self-report prevalence hearing loss 36%; audiometric hearing impairment prevalence 9% (low-frequency), 29% (mid-frequency) and 47% (high-frequency) |
Sensitivity moderate, specificity moderate | ||||||
In other frequencies lower agreement | ||||||
18 | Eskelinen et al. (1991) | General Health | Self-diagnosis | Overall SE = 0.82 [0.73, 0.89]; SP = 0.81 [0.71, 0.89] |
–
| |
Coronary artery disease (male) SE = 95.2; SP = 87.2 | ||||||
Lower back pain (female) SE = 79.5; SP = 73.1 | ||||||
Sensitivity moderate to high, specificity moderate to high | ||||||
19 | Åkesson et al. (1999) | MSD | Symptoms | Self-reported symptoms compared with clinical findings: | Higher sensitivity related to diagnoses, higher specificity related to clinical findings | |
Neck/shoulders: SE = 73% and SP 81% moderate/moderate | ||||||
Elbows/wrists/hands SE 50% and SP 87% low/high | ||||||
Hips SE 45% and SP 97% low/high | ||||||
Self-reported symptoms compared with diagnoses | ||||||
Neck/shoulders SE 89% and SP 55% high/low | ||||||
Elbows/wrists/hands SE 67% and SP 71% low/moderate | ||||||
Hips SE 67% and SP 89% low/high | ||||||
20 | Bjorksten et al. (1999) | MSD | Symptoms Pain rating scale | SE values 71–100; highest for shoulders (100%) and neck (92%) | ||
SP values 21–66; highest for neck (62%) and thoracic spine (66%) | ||||||
Current ailment/pain: SE = 95% and SP = 88% | ||||||
Sensitivity moderate to high, specificity low to moderate | ||||||
21 | Kaergaard et al. (2000) | MSD Upper Extremities | Symptoms | Self-reported symptoms compare to diagnosis of Myofascial pain syndrome: | Symptoms and clinical findings: | |
r = 0.54–0.62 moderate | ||||||
SE = 67–100%, SP = 68–74%, PPV = 31–33%, NPV = 92–93% | ||||||
Rotator cuff tendinitis: | ||||||
SE = 69–78%, SP = 79–84%, PPV = 16–19%, NPV = 99–100% Sensitivity low to high, specificity low to moderate | ||||||
22 | Mehlum et al. (2009) | MSD Upper Extremities | Symptoms, Work relatedness | Kappa values: k = 0.16–0.34 low | Prevalence of work-related illness based on self-report 6–14% higher than prevalence based on clinical examination | |
Higher agreement on diagnoses than on findings | ||||||
Positive specific agreement (worker and physician agreed on work relatedness) 76–85% > Negative specific agreement (worker and physician agreed on non-work relatedness) 37–51%. | ||||||
23 | Silverstein et al. (1997) | MSD | Symptoms | SE = 77–88%, SP = 21–38% | Self-report and physicians diagnoses: | Prevalence based on physicians’ interviews > prevalence based on self-report > physician’s diagnosis after examination |
Sensitivity moderate to high, specificity low | Neck k = 0.43, moderate | |||||
Shoulder k = 0.36, low | ||||||
Elbow k = 0.47, moderate | ||||||
Hand/wrist k = 0.42, moderate | ||||||
Low back k = 0.23, low | ||||||
24 | Toomingas et al. (1995) | MSD Upper Extremities | Self-administered examination | SE = 0–100%, SP = 63–99%; PPV = 0–36%, NPV = 92–100% | Kappa values of 14 tests <0.20 | SR-prevalence 2–3 times higher than CE prevalence |
Finger flexion deficit: k = 0.50 (0.15–0.84) | ||||||
Highly variable sensitivity and specificity | ||||||
Tenderness of—trapezius pars descendens: | ||||||
k = 0.27 (0.17–0.38) | ||||||
neck k = 0.34 (0.24–0.45) | ||||||
Shoulders k = 0.38 (0.26–0.50) | ||||||
25 | Zetterberg et al. (1997) | MSD | Symptoms | A strong significant correlation between the self-reported complaints and findings on clinical examination (at the 0.001 level). | Self-report prevalence was around 50% higher than prevalence based on clinical examination | |
Weak correlations between subjective complaints and specific tests like acromioclavicular sign or Finkelstein’s test. | ||||||
26 | Cvetkovski et al. (2005) | Hand eczema | Severity rating | SE = 64.8%, SP = 65.6%, PPV = 29.2%, NPV = 89.5% | Self-report prevalence 39.9% versus clinical examination prevalence 17.9% | |
Sensitivity low, specificity low | ||||||
27 | Bolen et al. (2007) | Respiratory disorders Work exacerbated asthma (WEA) | Daily log or post-test survey on symptoms and medication | Post-test symptoms SE = 15% SP = 87% | Self-report prevalence WEA 48% versus prevalence based on positive PEF 14% | |
Post-test medication use SE = 15%; SP = 89% | ||||||
Self-reported concurrent medication use SE = 62% SP = 65% | ||||||
Sensitivity low to moderate, specificity moderate to high | ||||||
28 | Johnson et al. (2009) | Respiratory disorders Obstructive respiratory disease | Symptoms | Wheeze SE = 76%, SP = 81% moderate/moderate | Sself-report prevalence 24% (95% CI 17–31%) | |
Wheeze w/o cold SE = 50%, SP = 87% low/high | ||||||
Chest tight at work SE = 50%, SP = 88% low/high | Prevalence based on physicians’ diagnoses 35% (95% CI 27–43%) | |||||
Short of breath while in a hurry SE = 89%, SP = 57% high/low | ||||||
Phlegm most days SE = 33%, SP = 85% low/moderate | ||||||
Good–excellent health SE = 83%, SP = 39% high/moderate | ||||||
29 | Kauffmann et al. (1997) | Respiratory disorders | Change in health status | Self-reported: “Feels worse” and FEV1-decline over 12 years are significant related (p < 0.001) in patients with asthma and chronic bronchitis | ||
30 | Nettis et al. (2003) | Latex allergy | Symptoms | Localized contact urticaria SE = 100%; SP = 88% high/high | Low to high depending on symptom reported | |
Generalized contact urticaria SE = 27%, SP = 88% low/high | ||||||
Conjunctivitis SE = 0%, SP = 72% low/moderate | ||||||
Rhinitis SE = 9%, SP = 76% low/moderate | ||||||
Dyspnoea SE = 27%, SP = 84% low/moderate | ||||||
31 | Lundström et al. (2008) | Neurological impairment | Symptoms | About 58–60% of all individuals are graded equally by self-report and sensory tests | ||
32 | Dasgupta et al. (2007) | Pesticide poisoning | Symptoms | Correlation of specific blood tests with separate symptoms: P ≤ 0.17 | ||
Correlation of specific blood test with symptom index: P = 0.05 |