Validity of self-reported educational level in the Tromso Study

Background: Self-reported data on educational level have been collected for decades in the Tromso Study, but their validity has yet to be established. Aim: To investigate the completeness and correctness of self-reported educational level in the Tromso Study, using data from Statistics Norway. In addition, we explored the consequence of using these two data sources on educational trends in cardiometabolic diseases. Methods: We compared self-reported and Statistics Norway-recorded educational level (primary, upper secondary, college/university <4 years, and college/university > 4 years) among 20,615 participants in the seventh survey of the Tromso Study (Tromso7, 2015-2016). Sensitivity, positive predictive value and weighted kappa were used to measure the validity of self-reported educational level in three age groups (40-52, 53-62, 63-99 years). Multivariable logistic regression was used to compare educational trends in cardiometabolic diseases between self-reported and Statistics Norway-recorded educational level. Results: Sensitivity of self-reported educational level was highest among those with a college/university education of 4 years or more (> 97% in all age groups and both sexes). Sensitivity for primary educational level ranged from 67% to 92% (all age groups and both sexes). The lowest positive predictive value was observed among women with a college/university education of 4 years or more (29-46%). Weighted kappa was substantial (0.52-0.59) among men and moderate to substantial (0.41-0.51) among women. Educational trends in the risk of cardiometabolic diseases were less pronounced when self-reported educational level was used. Conclusions: Self-reported educational level in Tromso7 is adequately complete and correct. Self-reported data may produce weaker associations between educational level and cardiometabolic diseases than registry-based data.