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Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS)

Pan, Yuwei; Pikhartova, Jitka; Bobak, Martin; Pikhart, Hynek; (2022) Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS). BMC Public Health , 22 (1) , Article 1863. 10.1186/s12889-022-14218-1. Green open access

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Abstract

Background Despite the widespread use of the single item self-rated health (SRH) question, its reliability has never been evaluated in Chinese population. Methods We used data from the China Health and Retirement Longitudinal Study, waves 1–4 (2011–2019). In wave 1, the same SRH question was asked twice, separated by other questions, on a subset of 4533 subjects, allowing us to examine the test–retest reliability of SRH. In addition, two versions of SRH questions (the WHO and US versions) were asked (n = 11,429). Kappa (κ), weighted kappa ($${\kappa}_{w}$$<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:msub> <mml:mi>κ</mml:mi> <mml:mi>w</mml:mi> </mml:msub> </mml:math>), and polychoric correlation coefficient (ρ) were used for reliability assessment. Cox proportional-hazards models were estimated to assess the predictive validity of SRH measurement for mortality over 7 years of follow up. To do so, relative index of inequality (RII) and slope index of inequality (SII) were estimated for each SRH scale. Results There was moderate to substantial test–retest reliability (κ = 0.54, $${\kappa}_{w}$$<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"> <mml:msub> <mml:mi>κ</mml:mi> <mml:mi>w</mml:mi> </mml:msub> </mml:math>=0.63) of SRH; 31% of respondents who used the same scale twice changed their ratings after answering other questions. There was strong positive association between the two SRH measured by the two scales (ρ &gt; 0.8). Compared with excellent/very good SRH, adjusted hazard ratios (HR) of death are 2.30 (95% CI, 1.70–3.13) for the US version and 1.86 (95% CI, 1.33–2.60) for the WHO version. Using slope indices of inequality, the WHO version estimated slightly larger mortality differences (RII = 3.50, SII = 15.53) than the US version (RII = 3.25, SII = 14.80). Conclusions In Chinese middle-aged and older population, the reliability of SRH is generally good, although the two commonly used versions of SRH scales could not be compared directly. Both indices predict mortality, with similar predictive validity.

Type: Article
Title: Reliability and predictive validity of two scales of self-rated health in China: results from China Health and Retirement Longitudinal Study (CHARLS)
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12889-022-14218-1
Publisher version: https://doi.org/10.1186/s12889-022-14218-1
Language: English
Additional information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creat iveco mmons. org/ licen ses/ by/4. 0/. The Creative Commons Public Domain Dedication waiver (http:// creat iveco mmons. org/ publi cdoma in/ zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Keywords: Reliability, Validity, Health status indicators, China, Longitudinal studies
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10156940
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