J Med Internet Res. 2013 15(8):e152
Lassale C, Péneau S, Touvier M, Julia C, Galan P, Hercberg S, Kesse-Guyot E.
Université Paris 13, Sorbonne Paris Cité, UREN (Nutritional Epidemiology Research Unit), Inserm (U557), Inra (U1125), Cnam, Bobigny, France.
With the growing scientific appeal of e-epidemiology, concerns arise regarding validity and reliability of Web-based self-reported data.
The objectives of the present study were to assess the validity of Web-based self-reported weight, height, and resulting body mass index (BMI) compared with standardized clinical measurements and to evaluate the concordance between Web-based self-reported anthropometrics and face-to-face declarations.
A total of 2513 participants of the NutriNet-Santé study in France completed a Web-based anthropometric questionnaire 3 days before a clinical examination (validation sample) of whom 815 participants also responded to a face-to-face anthropometric interview (concordance sample). Several indicators were computed to compare data: paired t test of the difference, intraclass correlation coefficient (ICC), and Bland-Altman limits of agreement for weight, height, and BMI as continuous variables; and kappa statistics and percent agreement for validity, sensitivity, and specificity of BMI categories (normal, overweight, obese).
Compared with clinical data, validity was high with ICC ranging from 0.94 for height to 0.99 for weight. BMI classification was correct in 93% of cases; kappa was 0.89. Of 2513 participants, 23.5% were classified overweight (BMI≥25) with Web-based self-report vs 25.7% with measured data, leading to a sensitivity of 88% and a specificity of 99%. For obesity, 9.1% vs 10.7% were classified obese (BMI≥30), respectively, leading to sensitivity and specificity of 83% and 100%. However, the Web-based self-report exhibited slight underreporting of weight and overreporting of height leading to significant underreporting of BMI (P<.05) for both men and women: -0.32 kg/m(2) (SD 0.66) and -0.34 kg/m(2) (SD 1.67), respectively. Mean BMI underreporting was -0.16, -0.36, and -0.63 kg/m(2) in the normal, overweight, and obese categories, respectively. Almost perfect agreement (ie, concordance) was observed between Web-based and face-to-face report (ICC ranged from 0.96 to 1.00, classification agreement was 98.5%, and kappa 0.97).
Web-based self-reported weight and height data from the NutriNet-Santé study can be considered as valid enough to be used when studying associations of nutritional factors with anthropometrics and health outcomes. Although self-reported anthropometrics are inherently prone to biases, the magnitude of such biases can be considered comparable to face-to-face interview. Web-based self-reported data appear to be an accurate and useful tool to assess anthropometric data.