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      Accuracy of Self-reported Human Papillomavirus Vaccination Status Among Gay and Bisexual Adolescent Males: Cross-sectional Study

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          Abstract

          Background

          Men who have sex with men are a risk group for anal human papillomavirus (HPV) and anal cancer. Australia introduced a universal school-based HPV vaccination program in 2013. Self-reported HPV vaccination status has been widely used in clinical and research settings, but its accuracy is understudied.

          Objective

          We aimed to examine the accuracy of self-reported HPV vaccination status among gay and bisexual adolescent males.

          Methods

          We included 192 gay and bisexual males aged 16-20 years from the Human Papillomavirus in Young People Epidemiological Research 2 (HYPER2) study in Melbourne, Australia. All participants had been eligible for the universal school-based HPV vaccination program implemented in 2013 and were asked to self-report their HPV vaccination status. Written informed consent was obtained to verify their HPV vaccination status using records at the National HPV Vaccination Program Register and the Australian Immunisation Register. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of self-reported HPV vaccination status.

          Results

          The median age of the 192 males was 19 (IQR 18-20) years. There were 128 males (67%) who had HPV vaccination records documented on either registry. Self-reported HPV vaccination had a sensitivity of 47.7% (95% CI 38.8%-56.7%; 61/128), a specificity of 85.9% (95% CI 75.0%-93.4%; 55/64), a positive predictive value of 87.1% (95% CI 77.0%-93.9%; 61/70), and a negative predictive value of 45.1% (95% CI 36.1%-54.3%; 55/122).

          Conclusions

          Self-reported HPV vaccination status among Australian gay and bisexual adolescent males underestimates actual vaccination and may be inaccurate for clinical and research purposes.

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          Most cited references25

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          Interrater reliability: the kappa statistic

          The kappa statistic is frequently used to test interrater reliability. The importance of rater reliability lies in the fact that it represents the extent to which the data collected in the study are correct representations of the variables measured. Measurement of the extent to which data collectors (raters) assign the same score to the same variable is called interrater reliability. While there have been a variety of methods to measure interrater reliability, traditionally it was measured as percent agreement, calculated as the number of agreement scores divided by the total number of scores. In 1960, Jacob Cohen critiqued use of percent agreement due to its inability to account for chance agreement. He introduced the Cohen’s kappa, developed to account for the possibility that raters actually guess on at least some variables due to uncertainty. Like most correlation statistics, the kappa can range from −1 to +1. While the kappa is one of the most commonly used statistics to test interrater reliability, it has limitations. Judgments about what level of kappa should be acceptable for health research are questioned. Cohen’s suggested interpretation may be too lenient for health related studies because it implies that a score as low as 0.41 might be acceptable. Kappa and percent agreement are compared, and levels for both kappa and percent agreement that should be demanded in healthcare studies are suggested.
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            Diagnostic tests 4: likelihood ratios.

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              HPV Vaccination and the Risk of Invasive Cervical Cancer

              The efficacy and effectiveness of the quadrivalent human papillomavirus (HPV) vaccine in preventing high-grade cervical lesions have been shown. However, data to inform the relationship between quadrivalent HPV vaccination and the subsequent risk of invasive cervical cancer are lacking.
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                Author and article information

                Contributors
                Journal
                JMIR Public Health Surveill
                JMIR Public Health Surveill
                JPH
                JMIR Public Health and Surveillance
                JMIR Publications (Toronto, Canada )
                2369-2960
                December 2021
                6 December 2021
                : 7
                : 12
                : e32407
                Affiliations
                [1 ] Melbourne Sexual Health Centre Alfred Health Melbourne Australia
                [2 ] Central Clinical School Faculty of Medicine, Nursing and Health Sciences Monash University Melbourne Australia
                [3 ] Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health The University of Melbourne Melbourne Australia
                [4 ] Department of Obstetrics and Gynaecology Melbourne Medical School The University of Melbourne Melbourne Australia
                [5 ] Murdoch Children’s Research Institute Melbourne Australia
                [6 ] Centre for Women’s Infectious Diseases The Royal Women's Hospital Melbourne Australia
                Author notes
                Corresponding Author: Eric PF Chow eric.chow@ 123456monash.edu
                Author information
                https://orcid.org/0000-0003-1766-0657
                https://orcid.org/0000-0001-9081-1664
                https://orcid.org/0000-0003-4094-0833
                https://orcid.org/0000-0001-9329-8501
                https://orcid.org/0000-0002-6869-311X
                https://orcid.org/0000-0003-0806-8475
                https://orcid.org/0000-0002-5556-4175
                https://orcid.org/0000-0002-8924-2043
                Article
                v7i12e32407
                10.2196/32407
                8691408
                34874884
                b02d04ab-ec53-4a4d-afe3-89561e5a5f74
                ©Eric PF Chow, Christopher K Fairley, Rebecca Wigan, Jane S Hocking, Suzanne M Garland, Alyssa M Cornall, Sepehr N Tabrizi, Marcus Y Chen. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 06.12.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included.

                History
                : 26 July 2021
                : 24 September 2021
                : 5 October 2021
                : 13 October 2021
                Categories
                Original Paper
                Original Paper

                human papillomavirus,vaccination,accuracy,self-reported,men who have sex with men,immunisation,public health,immunization,hpv vaccination,bisexual adolescents,bisexual men

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