Comparison of self-reported diagnosis of connective tissue disease with medical records in female health professionals - The Women's Health Cohort Study

To compare self-report of connective tissue disease (CTD) with medical reco rds, subjects were selected from 395,543 female health professionals with a nd without breast implants who reported CTD on mailed questionnaires from 1 992 to 1995. The authors identified 220 women with breast implants (exposed ) who self-reported CTD and a random sample of 879 women without breast imp lants (unexposed) who also self-reported CTD, matched by age and date of di agnosis. Medical records were reviewed using classification criteria from t he American College of Rheumatology or other published criteria. After up t o three requests and a telephone call, 27.7% of the women provided consent for medical record review. Exposed women appeared somewhat more likely (33. 2% vs. 26.3%, p = 0.04) to provide consent. Using medical record reviews fo r 90% of the women who provided consent, confirmation rates of definite CTD were similar among the exposed and unexposed (22.7% vs. 24.0%, p = 0.83). This study demonstrates the difficulty of obtaining consent for medical rec ord review of CTD reported to have occurred years ago in women with and wit hout breast implants. Confirmation rates were low but were similar in expos ed and unexposed. Despite the fact that the study had low participation rat es, the data suggest that relative risk estimates for any definite CTD amon g women with breast implants compared with women without breast implants wo uld be similar in analyses of self-reported or medical record-confirmed cas es.