OBJECTIVES This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. MATERIALS AND METHODS: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. RESULTS: The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. CONCLUSIONS: The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.
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OBJECTIVES The reproductive history of women has been suggested to have a possible influence on the risk of osteoporotic fractures. The purpose of this study was to assess the association between reproductive history and hip fractures in the elderly women. METHODS: The study subjects were drawn from women members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, whose reproductive histories were available, and who were beneficiaries of the Korea Medical Insurance Corporation (KMIC) in 1993 and lived in Busan city, Korea. The information on reproductive histories, and possible confounders, were collected from mailed questionnaires. Potential hip fracture cases were collected from the claims data obtained between 1993 and 1998, with a hospital survey conducted to confirm the final diagnoses. Rate ratios and their 95% confidence intervals, were calculated using a Cox's proportional hazard model. RESUJLTS: Following up 5,219 women for 6 years, 51 cases were confirmed with hip fractures. When adjusted for age, weight and physical activity, the rate ratio of hip fractures in women who had given birth three or more times was 0.56 (95% CI: 0.25 - 1.25), compared with those who had given birth two or less times. When adjusted for age, number of births, weight and physical activity, the rate ratio in women who first gave birth when younger than 22 years was 0.60 (95% CI: 0.34 - 1.08) compared with those who had giving birth at 22 years or older. CONCLUSIONS: According to these findings, an early age when first giving birth might decrease the risk of hip fractures in elderly Korean women.