Background: Self-report questionnaires are commonly used in epidemiology, but may be susceptible to
misclassification, especially if answers are given on behalf of others, e.g. children or parents. The aim was to
determine agreement and analyse predictors of disagreement in parents’ reports of offspring asthma, and in
offspring reports of parents’ asthma.
Methods: In the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study, 6752
offspring (age range 18–51 years) and their parents (age range 39–66 years) reported their own and each other’s
asthma status. Agreement between asthma reports from offspring and parents was determined by calculating
sensitivity, specificity, positive and negative predictive value and Cohen’s kappa. The participants’ own answers
regarding themselves were defined as the gold standard. To investigate predictors for disagreement logistic
regression analyses were performed to obtain odds ratios (OR) with 95% confidence intervals (CI) for sex, smoking
status, education, comorbidity and severity of asthma.
Results: Agreement was good for parental report of offspring early onset asthma (< 10 years, Cohen’s kappa 0.72)
and moderate for offspring later onset asthma (Cohen’s kappa 0.46). Specificity was 0.99 for both, and sensitivity
was 0.68 and 0.36, respectively. For offspring report of maternal and paternal asthma the agreement was good
(Cohen’s kappa 0.69 and 0.68), specificity was 0.96 and 0.97, and sensitivity was 0.72 and 0.68, respectively. The
positive predictive value (PPV) was lowest for offspring report of maternal asthma (0.75), and highest for parents’
report of early onset asthma in the offspring (0.83). The negative predictive value (NPV) was high for all four groups
(0.94–0.97). In multivariate analyses current smokers (OR = 1.46 [95% CI 1.05, 2.02]) and fathers (OR = 1.31 [95% CI 1.
08, 1.59]) were more likely to report offspring asthma incorrectly. Offspring wheeze was associated with reporting
parental asthma incorrectly (OR = 1.60 [95% CI 1.21, 2.11]), both under- and over reporting.
Conclusions: Asthma reports across generations show moderate to good agreement, making information from
other generations a useful tool in the absence of direct reports.