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Open Access Research article

Agreement between self-reported and measured weight and height collected in general practice patients: a prospective study

Sze Lin Yoong1*, Mariko Leanne Carey1, Catherine D’Este12 and Robert William Sanson-Fisher1

Author Affiliations

1 Priority Research Center for Health Behavior & Hunter Medical Research Institute, Newcastle Australia, University of Newcastle, Callaghan, 2308, Australia

2 Center for Clinical Epidemiology and Biostatistics, University of Newcastle, Callaghan, 2308, Australia

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BMC Medical Research Methodology 2013, 13:38  doi:10.1186/1471-2288-13-38

Published: 13 March 2013

Abstract

Background

Self-reported weight and height is frequently used to quantify overweight and obesity. It is however, associated with limitations such as bias and poor agreement, which may be a result of social desirability or difficulties with recall. Methods to reduce these biases would improve the accuracy of assessment of overweight and obesity using patient self-report. The level of agreement between self-reported and measured weight and height has not been widely examined in general practice patients.

Methods

Consenting patients, presenting for care within four hour sessions, were randomly allocated to the informed or uninformed group. Participants were notified either a) prior to (informed group), or b) after (uninformed group) reporting their weight and height using a touchscreen computer questionnaire, that they would be measured. The differences in accuracy of self-report between the groups were examined by comparing mean differences, intraclass correlations (ICCs), Bland Altman plot with limits of agreement (LOAs) and Cohen’s kappa. Overall agreement was assessed using similar statistical methods.

Results

Of consenting participants, 32% were aged between 18–39 years, 42% between 40–64 years and 25% were 65 years and above. The informed group (n = 172) did not report their weight and height more accurately than the uninformed group (n = 160). Mean differences between self-reported and measured weight (p = 0.4004), height (p = 0.5342) and body mass index (BMI) (p = 0.4409) were not statistically different between the informed and uninformed group. Overall, there were small mean differences (−1.2 kg for weight, 0.8 for height and −0.6 kg/m2 for BMI) and high ICCs (>0.9) between self-reported and measured values. A substantially high kappa (0.70) was obtained when using self-reported weight and height relative to measured values to quantify the proportion underweight, normal weight, overweight or obese. While the average bias of self-reported weight and height as estimates of the measured quantities is small, the LOAs indicate that substantial discrepancies occur at the individual level.

Conclusions

Informing patients that their weight and height would be measured did not improve accuracy of reporting. The use of self-reported weight and height for surveillance studies in this setting appears acceptable; however this measure needs to be interpreted with care when used for individual patients.

Keywords:
Obesity; Family practice; Weight