(1997) Respiratory disorders Change in health status Self-reported: “Feels worse” and FEV1-decline over 12 years are significant related (p < 0.001) in patients with asthma and chronic bronchitis     30 Nettis et al. (2003) Latex allergy Symptoms Localized contact urticaria SE = 100%; BMS202 manufacturer SP = 88% high/high   Low to high depending on symptom reported Generalized contact urticaria SE = 27%, SP = 88% low/high Conjunctivitis SE = 0%, SP = 72% low/moderate Rhinitis SE = 9%, SP = 76% low/moderate Dyspnoea SE = 27%, SP = 84%

low/moderate 31 Lundström et al. (2008) Neurological impairment Symptoms   About 58–60% of all individuals are graded equally by self-report and sensory tests   32 Dasgupta et al. (2007) Pesticide poisoning Symptoms   Correlation of specific blood tests with separate symptoms: P ≤ 0.17   Correlation of specific blood test with symptom

index: P = 0.05 GS global score, i.e., summary of pain scores on a numerical scale; HEW-EHAS health, education and welfare-expanded hearing ability scale, MSD musculoskeletal disorder, NMQ nordic musculoskeletal questionnaire, NPV negative predictive value, PPV BI 10773 clinical trial positive predictive value, PR prevalence rate, FEV1 AZD3965 forced expiratory volume in 1 s, SE sensitivity, SP specificity Agreement between self-report and expert assessment Thirteen studies presented results on the agreement between self-report and expert assessment (Table 2). The kappa values varied from <0.20 to 0.77, the percentages of agreement varied from 58 to 80%, and the correlation coefficients from <0.17 to 0.62. For two studies, only the significance of the correlation was reported, so the agreement level was not assessable. Overall, the agreement between self-reported illness and expert assessed disease was low to moderate. Sensitivity and specificity of self-report The results on sensitivity and specificity reflected the predictive value of self-reported illness to predict experts’ assessed disease. Nineteen studies (two studies by Descatha et al. 2007) contained enough data to combine in a forest plot (Fig. 3). The data were

categorized MRIP according to the type of self-report: (1) questionnaires asking for symptoms, regardless of cutoff value (Symp Quest); (2) single-item questionnaires asking for self-diagnosis (Self Diag), and (3) scales rating severity of symptoms or illness (severity rate). Eight studies presented also data on sensitivity and specificity but did not contain enough data on true vs. false positives or negatives to include in the forest plot. These studies are summarized in Table 3. Fig. 3 Forest plot of 19 included studies, categorized by type of self-report measure. TP true positive, FP false positive, FN false negative, TN true negative. Between the brackets the 95% confidence intervals (CI) of sensitivity and specificity.