Skip to main content
PMC home page
American Journal of Public Health logoLink to American Journal of Public Health
. 1991 Apr;81(4):466–470. doi: 10.2105/ajph.81.4.466

The validity of health risk appraisals for coronary heart disease: results from a randomized field trial.

K W Smith 1, S M McKinlay 1, J B McKinlay 1
PMCID: PMC1405058  PMID: 2003626

Abstract

BACKGROUND: While health risk appraisals (HRAs) are becoming increasingly popular as tools for health assessment and health education, comparatively little is known about the accuracy of these risk estimates. METHODS: A field trial among 732 randomly selected adults ages 25 to 65 years was conducted to assess the validity of the risk scores produced by four widely used HRAs. RESULTS: Self-reported HRA risk scores for cigarette smoking and relative weight were generally accurate, but correlations between physiological measurements and scores for blood pressure, cholesterol, and physical activity were always lower than .51. Correlations between epidemiologic estimates of the probability of CHD death and HRA total risk scores ranged from .13 to .75; partial correlations adjusting for age, race, and gender ranged from .12 to .47. CONCLUSIONS: The HRAs chosen for the field trial exhibited modest correlations with the CHD mortality risk predicted by the epidemiologic model. Mathematical errors made by respondents completing self-scored instruments and lack of knowledge regarding physiologic status decrease the accuracy of HRA risk estimates.

Full text

PDF
466

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Fielding J. E. Appraising the health of health risk appraisal. Am J Public Health. 1982 Apr;72(4):337–340. doi: 10.2105/ajph.72.4.337. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Fielding J. E., Piserchia P. V. Frequency of worksite health promotion activities. Am J Public Health. 1989 Jan;79(1):16–20. doi: 10.2105/ajph.79.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Foxman B., Edington D. W. The accuracy of health risk appraisal in predicting mortality. Am J Public Health. 1987 Aug;77(8):971–974. doi: 10.2105/ajph.77.8.971. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Kramer M. S., Feinstein A. R. Clinical biostatistics. LIV. The biostatistics of concordance. Clin Pharmacol Ther. 1981 Jan;29(1):111–123. doi: 10.1038/clpt.1981.18. [DOI] [PubMed] [Google Scholar]
  5. Leaverton P. E., Sorlie P. D., Kleinman J. C., Dannenberg A. L., Ingster-Moore L., Kannel W. B., Cornoni-Huntley J. C. Representativeness of the Framingham risk model for coronary heart disease mortality: a comparison with a national cohort study. J Chronic Dis. 1987;40(8):775–784. doi: 10.1016/0021-9681(87)90129-9. [DOI] [PubMed] [Google Scholar]
  6. Maclure M., Willett W. C. Misinterpretation and misuse of the kappa statistic. Am J Epidemiol. 1987 Aug;126(2):161–169. doi: 10.1093/aje/126.2.161. [DOI] [PubMed] [Google Scholar]
  8. Paffenbarger R. S., Jr, Hyde R. T., Wing A. L., Hsieh C. C. Physical activity, all-cause mortality, and longevity of college alumni. N Engl J Med. 1986 Mar 6;314(10):605–613. doi: 10.1056/NEJM198603063141003. [DOI] [PubMed] [Google Scholar]
  9. Schoenbach V. J. Appraising health risk appraisal. Am J Public Health. 1987 Apr;77(4):409–411. doi: 10.2105/ajph.77.4.409. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Smith K. W., McKinlay S. M., McKinlay J. B. The reliability of health risk appraisals: a field trial of four instruments. Am J Public Health. 1989 Dec;79(12):1603–1607. doi: 10.2105/ajph.79.12.1603. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Smith K. W., McKinlay S. M., Thorington B. D. The validity of health risk appraisal instruments for assessing coronary heart disease risk. Am J Public Health. 1987 Apr;77(4):419–424. doi: 10.2105/ajph.77.4.419. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from American Journal of Public Health are provided here courtesy of American Public Health Association

RESOURCES