Arthritis screens: Self-diagnosed vs. diagnosed by a health professional

Background: Centers for Disease Control (CDC) is currently assessing the value of BRFSS' self-diagnosis screen for arthritis. Possible elimination of the self-diagnosis screen poses intriguing implications for public health policy with reference to the conditions of minority communities, the uninsured and other hard-to-reach population.

Methods: Six hundred Latino adults in Oregon were interviewed using the CDC's arthritis eligibility screening questions. A convenience sampling approach and a combination of face-to-face and telephone surveys were used.

Findings: Fifty five percent of the survey participants were self diagnosed while 45% were physician diagnosed. We found no statistical differences between the two groups in terms of belief systems, use of over-the-counter drugs, application of home therapies and other approaches for arthritis. Physician diagnosed were more likely to be women, older, married, and less likely to be employed. Not surprisingly, the physician diagnosed participants have higher rates of insurance; use more prescription drugs, higher rates of co-morbidities and visit health clinics and alternative therapists more often. The physician diagnosed participants had statistically significant higher mean pain, and greater functional limitations leading to more time off from work and change jobs.

Conclusions: There is scarcity of data on the consequence of eliminating the self-diagnosed arthritis population from the annual surveys. Even though the two groups are similar on a variety of measures, sole reliance on the doctor diagnosed group may lead to over estimation of insurance, the levels of pain, prescription use, and disability. These findings have important public health policy implications.