Abstract
Study objectives: To assess the extent to which poorer self assessed health in men in whom an abdominal aortic aneurysm (AAA) is detected at screening is a consequence or a predictor of screening outcome.
Design: Prospective study.
Setting: Community based screening.
Participants: 23 654 men who attended for AAA screening as part of the UK multicentre aneurysm screening study completed a measure of self assessed health before screening. A total of 1156 had an aneurysm detected. A sub-sample of screened men (571 with an aneurysm and 609 with a normal aorta) also completed the measure of self assessed health six weeks after screening.
Main results: Men in whom an aneurysm was detected at screening perceived their health to be poorer before screening than those with a normal aorta. Adjusting for risk factors for AAA made no difference to this result: self assessed health remained a strong predictor of having an aneurysm (odds ratio 1.7 comparing the extreme quartiles of self assessed health, 95% confidence intervals: 1.4 to 2.0). Men with an aneurysm also perceived their health to be poorer after screening had detected their aneurysms, but only to an extent in line with their pre-screening perceptions.
Conclusions: Self assessed health seems to predict having an aortic aneurysm, independently of known risk factors. This emphasises the importance of assessing baseline perceptions of health to prevent erroneously inferring that poorer self assessed health in those who screen positive is a consequence as compared with a predictor of screening outcome.
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Selected References
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- Benyamini Y., Leventhal E. A., Leventhal H. Gender differences in processing information for making self-assessments of health. Psychosom Med. 2000 May-Jun;62(3):354–364. doi: 10.1097/00006842-200005000-00009. [DOI] [PubMed] [Google Scholar]
- Bloom J. R., Monterossa S. Hypertension labeling and sense of well-being. Am J Public Health. 1981 Nov;71(11):1228–1232. doi: 10.2105/ajph.71.11.1228. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Havas S., Reisman J., Hsu L., Koumjian L. Does cholesterol screening result in negative labeling effects? Results of the Massachusetts Model Systems for Blood Cholesterol Screening Project. Arch Intern Med. 1991 Jan;151(1):113–119. [PubMed] [Google Scholar]
- Houts P. S., McDougall V. Effects of informing workers of their health risks from exposure to toxic materials. Am J Ind Med. 1988;13(2):271–279. doi: 10.1002/ajim.4700130208. [DOI] [PubMed] [Google Scholar]
- Idler E. L., Angel R. J. Self-rated health and mortality in the NHANES-I Epidemiologic Follow-up Study. Am J Public Health. 1990 Apr;80(4):446–452. doi: 10.2105/ajph.80.4.446. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Idler E. L., Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997 Mar;38(1):21–37. [PubMed] [Google Scholar]
- Idler E. L., Kasl S. Health perceptions and survival: do global evaluations of health status really predict mortality? J Gerontol. 1991 Mar;46(2):S55–S65. doi: 10.1093/geronj/46.2.s55. [DOI] [PubMed] [Google Scholar]
- Idler E. L., Russell L. B., Davis D. Survival, functional limitations, and self-rated health in the NHANES I Epidemiologic Follow-up Study, 1992. First National Health and Nutrition Examination Survey. Am J Epidemiol. 2000 Nov 1;152(9):874–883. doi: 10.1093/aje/152.9.874. [DOI] [PubMed] [Google Scholar]
- Lederle F. A., Johnson G. R., Wilson S. E., Chute E. P., Hye R. J., Makaroun M. S., Barone G. W., Bandyk D., Moneta G. L., Makhoul R. G. The aneurysm detection and management study screening program: validation cohort and final results. Aneurysm Detection and Management Veterans Affairs Cooperative Study Investigators. Arch Intern Med. 2000 May 22;160(10):1425–1430. doi: 10.1001/archinte.160.10.1425. [DOI] [PubMed] [Google Scholar]
- Meurer L. N., Layde P. M., Guse C. E. Self-rated health status: a new vital sign for primary care? WMJ. 2001;100(7):35–39. [PubMed] [Google Scholar]
- Murray J., Dunn G., Tarnopolsky A. Self-assessment of health: an exploration of the effects of physical and psychological symptoms. Psychol Med. 1982 May;12(2):371–378. doi: 10.1017/s0033291700046705. [DOI] [PubMed] [Google Scholar]
- STENBACK A. PHYSICAL HEALTH AND PHYSICAL DISEASE AS OBJECTIVE FACT AND SUBJECTIVE EXPERIENCE. Arch Gen Psychiatry. 1964 Sep;11:290–301. doi: 10.1001/archpsyc.1964.01720270062008. [DOI] [PubMed] [Google Scholar]
- Shaw C., Abrams K., Marteau T. M. Psychological impact of predicting individuals' risks of illness: a systematic review. Soc Sci Med. 1999 Dec;49(12):1571–1598. doi: 10.1016/s0277-9536(99)00244-0. [DOI] [PubMed] [Google Scholar]
- Vardulaki K. A., Walker N. M., Day N. E., Duffy S. W., Ashton H. A., Scott R. A. Quantifying the risks of hypertension, age, sex and smoking in patients with abdominal aortic aneurysm. Br J Surg. 2000 Feb;87(2):195–200. doi: 10.1046/j.1365-2168.2000.01353.x. [DOI] [PubMed] [Google Scholar]
- Vingilis Evelyn R., Wade Terrance J., Seeley Jane S. Predictors of adolescent self-rated health. Analysis of the National Population Health Survey. Can J Public Health. 2002 May-Jun;93(3):193–197. doi: 10.1007/BF03404999. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ware J. E., Jr, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol. 1998 Nov;51(11):903–912. doi: 10.1016/s0895-4356(98)00081-x. [DOI] [PubMed] [Google Scholar]