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PubMed2004

[Development of a Hebrew questionnaire to be used in epidemiological studies to assess physical fitness--validation against sub maximal stress test and predicted VO2max].

BACKGROUND: The physical activity questionnaire is typically chosen for population studies because it is practical and does not interfere with the behavior of the surveyed individual. This instrument can be adapted for the particular studied population, and in terms of accuracy it is both reliable and valid. AIM: To develop a valid and appropriate measure to assess physical fitness according to the level of physical activity throughout the day, and to estimate the relation between a subjective questionnaire measurement evaluating physical activity, to predicted VO2max, as an objective measure of physical fitness. METHODS: Three hundred healthy subjects, 150 men and 150 women, aged 25-65 years old participated in this study. All subjects were routinely examined in the Sheba Medical Center Executive Screening Survey. They were asked to complete a self-administered questionnaire and report on the level of physical activity at work, the level of sports activity and the level of leisure time non-sport activity. The index calculated from the questionnaire was compared to the result from a sub-maximal exercise test, which they performed in The Executive Screening Survey, to composite a valid questionnaire to estimate physical fitness. RESULTS: A high and statistically significant correlation (r = 0.64, P < 0.01) was found between the indexes of physical activity calculated from the questionnaire to the predicted VO2max, measured from the sub-maximal exercise test. The reliability of the questionnaire was examined by test-retest and a high and statistically significant correlation (r = 0.89, P < 0.01) was found between the first and the proceeding one month administration of the questionnaire. The final modal to predict VO2max included a total index of physical activity, gender, BMI, age and resting heart rate. Overall this model predicted 58% of the VO2max. CONCLUSIONS: The self-administered questionnaire developed in this study has high construct validity and a significant correlation to predicted VO2max, with high sensitivity in both sexes and among active and non-active subjects. It is therefore an appropriate tool to be used in epidemiological studies.

Adult↗
PubMed1992

A self-administered hip-rating questionnaire for the assessment of outcome after total hip replacement.

The hip-rating questionnaire was developed for the assessment of the outcome of total hip replacement. The purpose of this study was to evaluate its reproducibility, validity, and responsiveness. The questionnaire uses a 100-point scale in which equal weight is given to the domains of global or over-all impact of arthritis, pain, walking, and function. Ninety-eight patients were enrolled in the prospective study and have been followed for at least three months; sixty-two patients have been followed for six months; and forty-two patients have been followed for one year. Reproducibility was tested with the use of the kappa statistic in fifty patients whose condition was stable clinically, and it was found to be good or excellent both for individual questions and for the total score. The validity of the questionnaire was assessed by comparison with the scores from a six-minute walking-distance test and arthritis impact-measurement scales. The result of the six-minute walking-distance test correlated with the patient's response concerning walking distance on the hip-rating questionnaire. The score for pain from the hip-rating questionnaire correlated well with the score for pain from the arthritis impact-measurement scales, and the total score from the hip-rating questionnaire correlated well with the total score from the arthritis impact-measurement scales. The score on the hip-rating questionnaire was responsive to the change in the clinical condition of the patient, as indicated by a favorable index of responsiveness. The results of the questionnaire were sensitive enough to demonstrate differences among treatment groups with relatively small sample sizes. This questionnaire has the characteristics of a useful instrument for assessment of outcomes, such as that after an operation.

Activities of Daily Living↗
PubMedDate not supplied

Validation and reproducibility of a food frequency questionnaire to assess energy and fat intake in affluent north Indians.

BACKGROUND: India is currently witnessing a sharp rise in noncommunicable disorders such as obesity, diabetes, hypertension and cardiovascular diseases. This rise can be related in part to dietary changes such as increased intake of calories, fat (especially saturated fat) and cholesterol. A simple, accurate and reproducible method to measure these nutrients is essential to study the role of diet in these diseases in epidemiological studies. We aimed to develop and validate a food frequency questionnaire that could be used for this purpose. METHODS: Thirty urban north Indian subjects (age 23-64 years, 16 men) belonging to a high socioeconomic group were studied. The subjects were selected consecutively over a period of 3 weeks from among those participating in an epidemiological survey on cardiovascular risk factors in an affluent population. A 102-item food frequency questionnaire was developed to capture the intake of calories, fat, saturated fat and cholesterol. The results obtained by the food frequency questionnaire were compared with a 5-day diet record. To assess the reproducibility of the food frequency questionnaire, it was re-administered after 3 months to the 23 subjects available. RESULTS: It took the dietician 20 minutes or less to administer the questionnaire. There was good correlation between the nutrient values as calculated by the food frequency questionnaire and 5-day diet record. The correlation for energy intake was 0.80, and varied between 0.55 and 0.69 for unadjusted intake of other nutrients. After adjusting for calories, the correlation varied between 0.45 and 0.68. In general, the food frequency questionnaire overestimated the energy-adjusted nutrient intake by 6%-17%. When intake was classified into quartiles, there was good agreement between the two methods: 43%-100% for calories; 29%-86% for other nutrients for unadjusted intake; 29%-71% for nutrients after energy adjustment. On calculation of intake after re-administration of the food frequency questionnaire, there was a moderate to strong correlation (energy adjusted r=0.49-0.90) between the two evaluations for various nutrients. CONCLUSION: The food frequency questionnaire developed for the assessment of nutrient intake in a north Indian population was easy to administer, showed moderate to good correlation with the 5-day diet record and was reproducible.

Adult↗
PubMed1990

The relative value of consultation, questionnaires and laboratory investigation in the identification of excessive alcohol consumption.

Alcohol is a major cause of morbidity and mortality in Britain. Consultation, questionnaires and laboratory tests may all be used to help identify alcohol abuse and thereby prevent and treat alcohol-related problems. Consultation which can identify 80% of alcohol abusers involves recording the findings of alcohol and general histories and physical examination. The accuracy of the assessment depends on the reliability of the respondent and the respondent's relations and friends, and on the skill of the investigator; however, thorough assessment is time-consuming and expensive. Questionnaires may identify up to 80% of alcoholics. They are generally based on the Michigan Alcohol Screening Test and CAGE questionnaires and are simple, rapid to complete, inexpensive and not dependent on skilled investigators; however, the principal disadvantage of using questionnaires is that a personal relationship is not developed with the subject. Finally, simple and complex laboratory tests may be used. Of the simple laboratory tests, raised GGT or MCV levels are the most useful and when these values are combined, 90% of alcoholics may be identified correctly. Complex laboratory tests may exhibit greater sensitivity and specificity and provide useful additional information; however, their restricted availability limits their widespread use. The value of each of these methods depends on the objective of the assessment. For population surveys, questionnaires are of greatest relative value and consultation and laboratory tests may be used to confirm the presence of alcohol abuse. In general practice and the hospital setting, it is imperative to include questions on alcohol intake and alcohol-related problems in all interviews with patients. Laboratory tests may be used to confirm suspected alcohol abuse and questionnaires may provide useful screening tools. Finally, in the specialist alcohol unit, consultation, questionnaires and laboratory investigations are all important for identifying alcohol abuse. In this setting, consultation is of particular importance and the alcohol history and physical examination should be recorded by a skilled investigator and the results confirmed with relatives and close friends. Questionnaires are useful as initial screening or assessment tools and computer-based systems may facilitate data collection. Simple and complex laboratory tests may be used to confirm the diagnosis and help ascertain the extent of disease. By assuming that 'all patients have alcohol-related problems until proven otherwise', and through the appropriate application of consultation, questionnaires and laboratory tests, identification of excessive alcohol consumption and the prevention of its sequelae will be facilitated.

Alcoholism↗
PubMed1993

[Evaluation of the design and reliability of a questionnaire to identify elderly individuals in need for social and health services].

BACKGROUND: To assess the construction of a short screening questionnaire designed for the detection of elderly people living in the community and in need of social and health care, and to test the reliability of the scores obtained on the scales of Activities of Daily Living (ADL) and mobility through its application. METHODS: A short screening questionnaire of 11 items was designed to score elderly community dwellings on the scales of ADL and mobility of the International Classification of Impairments, Disabilities and Handicaps of the WHO (ICIDH). A random sample of 1,000 people aged 65 and over from the community of a geographical area of Catalonia (Spain) were interviewed in 1989, either by telephone or in-home personal interview, by non-professional trained interviewers on the basis of the mentioned schedule, and scored on the ICIDH ADL and Mobility scales. The design of the screening questionnaire was evaluated on the construction, content and wording through a 16 opinion statements questionnaire upon which 12 professionals, familiarized with questionnaire construction, expressed agreement or disagreement. To test reliability, each interviewer re-scored, one month apart, 20 subjects based on the information they had registered on the questionnaires, and following the same procedure, a gold standard observer re-scored all 1,000 interviews. In addition, a number of interviews were tape recorded, with previous consent of the subjects, and re-scored by 9 different observers. Interobserver and intraobserver reliability was measured with Cohen's weighted kappa coefficient. RESULTS: The average time of questionnaire administration was approximately 10 +/- 5 min. Although the instrument was said to be a good tool for the interviewer to score the subjects on the scales, wording of some items of the questionnaire need to be reviewed. Both intraobserver and interobserver reliability were high: kappa coefficients of 0.79-0.97 and > 0.75 respectively. CONCLUSIONS: The use of a simple and reliable ADL and mobility questionnaire is a practical way to obtain information on the functional status of elderly people living at home, and to select elderly people for a further comprehensive assessment of their social and health care needs for planning the appropriate services in the community.

Activities of Daily Living↗
PubMed1998

The role of the general health questionnaire in general practice consultations.

BACKGROUND: The patient self-rating questionnaire is commonly used as a research tool to identify patients with 'unrecognized' depression. There is no evidence to support its use as a clinical tool in general practice. AIM: To determine whether use of the 30-item general health questionnaire (GHQ) is a practical means of increasing identification of 'new' episodes of emotional distress among patients consulting their general practitioner (GP). METHOD: A randomized controlled trial was carried out in a Scottish new town practice with eight partners. In the waiting room, 1912 patients aged over 14 years and consulting over a 10-month period attempted to complete the GHQ. The 'clinical judgement' group posted the questionnaire into a box then attended the doctor as normal. The 'screened' group presented the questionnaire to the doctor. After the consultation, the doctor completed an assessment questionnaire. The main outcome measures were GHQ scores and doctors' assessments of mental health. RESULTS: In total, 1589 patients were eligible to participate. However, 207 patients in the screened group were excluded because the doctor did not look at the questionnaire. The clinical judgement group (59.7% patients) and the screened group (40.3%) were compared. Although the doctors' diagnoses of distress were low in the clinical judgement group (8.1%), they were significantly greater in the screened group (13.9%) where the diagnosis of depression was doubled. The percentage of patients scoring greater than or equal to 9 (GHQ+) was 21.5% and 21.0% respectively. The level of agreement between the doctors' diagnoses of distress and the questionnaires scoring GHQ+ rose from 19% in the clinical judgement group to 35% in the screened group. CONCLUSIONS: The general health questionnaire used in a practice setting increases the identification of patients with emotional distress. However, the use made of the questionnaires in the screened group raises questions of doctor and patient acceptability.

Adult↗
PubMed1997

Enhancement of the value of hip questionnaires by telephone follow-up evaluation.

Errors, omissions, false understanding, and contradictory answers can compromise the use of questionnaires to generate follow-up data. To assess the utility of and effort involved in adding routinely a telephone interview to clarify the questionnaire, a study of total hip arthroplasty patients was carried out. Thirty-six patients with 37 primary and 13 revision total hip arthroplasties filled out a standardized questionnaire (which asks a number of demographic questions as well as questions that allow calculation of the Medical Outcome Studies [MOS] 36-Item Short-form Health Survey [SF-36], Western Ontario MacMaster Arthritis Center [WOMAC] osteoarthritis index, and Harris hip score) prior to returning for routine follow-up evaluation a minimum of 1 year after surgery. Two hundred thirty-two of a possible 4,350 responses (5.3%) were missing, contradictory, or answered with two or more answers on the questionnaire. Only eight such defects occurred following the telephone interview by a skilled orthopaedic surgeon, representing a significant reduction in these defects (P < .005). The average time of the telephone call was 2.8 minutes (range, 1-12 minutes), and the average number of attempts to contact the patient was 1.4 (range, 1-6). All questionnaire data and questionnaire data plus telephone data were compared with data obtained from a subsequent face-to-face interview by a different skilled orthopaedic surgeon who was blinded to the data from both the questionnaire and the telephone interview. It is demonstrated that a telephone call to follow up a standardized, self-administered questionnaire is a very effective way to augment the quality and quantity of questionnaire responses.

Adult↗
PubMed2002

[Some psychometric attributes of the Family Assessment Questionnaires].

In this article we present some of the more important findings from research aimed at the validation and normalisation of the Family Assessment Questionnaire (Dyadic Questionnaire, Family Questionnaire, Self-Estimation Questionnaire), which is the Polish adaptation of Manfred Cierpka's and Gabriele Frevert's "Familienboegen". In the presented study 1511 individuals from 557 families took part. Of these 658 individuals (including 162 children) came from 248 families which had no clinical health or adjustment problems, while 853 individuals (including 305 children) came from 309 families with problems due to schizophrenia, anorexia nervosa, coronary heart disease or family crisis. A new method of analysing raw results from the questionnaire scales was formulated and verified. This method was based on the criterium of sufficient satisfaction regarding the aspect of family life measured by the scale. The original scales of all the questionnaires (Task Completion, Role Performance, Communication, Emotionality, Affective Involvement, Control, and Values and norms) were characterised by average or low reliability; the general scales were characterised by high reliability (the Dyadic Questionnaire with very high reliability). As a result of factor analysis new scales were created with acceptable or high reliability. These were the scale of Positive statements, the scale of Negative statements in the dyadic and family questionnaires, and the scales of kindness, care and resentment in the Self-Estimation Questionnaire. The general scales and the factor scales generally significantly differentiated between the sub-samples selected due to the type of family problems present and relationship. On the other hand the 7 original scales did so only sporadically or weakly. Better results were obtained by families without health or adjustment problems while the worst results were obtained by families in crisis.

Evaluation Studies as Topic↗
PubMed1996

Cross-cultural adaptation of a brief outcome questionnaire for Spanish-speaking arthritis patients.

OBJECTIVE: To cross-culturally adapt a brief self-assessment questionnaire to measure outcome among English- or Spanish-speaking patients with arthritis. METHODS: A questionnaire containing the following items was translated to Spanish: the 8 activities of daily living (ADL) question of the Modified Health Assessment Questionnaire; a question about the duration of morning stiffness; and a 10-point pain scale. Equivalence to the original English, test-retest reliability, and construct, criterion, and discriminant validity were determined on a population of patients with 4 clinical centers. RESULTS: English-Spanish equivalence and test-retest reliability of the questionnaire were almost perfect (intra-class correlation coefficients [ri] > or = 0.90 for each). Construct validity, measured by comparing questionnaire scores with an occupational therapist's evaluation, was also near-perfect in both languages (ri = 0.93 for English and 0.89 for Spanish). Both versions of the questionnaire correlated well with the physician-determined Steinbrocker functional class, as well as with the amount of pain, grip strength, and walking velocity. Patients with systemic lupus erythematosus, rheumatoid arthritis, osteoarthritis, and fibromyalgia differed significantly in their pain:ADL ratios, in both languages. CONCLUSIONS: The items of the Spanish questionnaire that we have adapted are equivalent to the original English versions. This questionnaire is suitable for studying Spanish-speaking subjects with arthritis in the US and elsewhere.

Activities of Daily Living↗
PubMed1998

Validation of questionnaire-based response criteria of treatment efficacy in the fibromyalgia syndrome.

OBJECTIVE: To compare the validity of self-reported questionnaires as response criteria of treatment efficacy in patients with fibromyalgia syndrome. METHOD: At the beginning of the treatment period, 70 fibromyalgia patients, randomly allocated to electro-acupuncture or placebo, underwent a clinical evaluation by rheumatologists and answered 1) a generic quality of life questionnaire--the Psychological General Well-Being Index (PGWB), 2) a specific function and symptom questionnaire, and 3) a pain questionnaire--the Regional Pain Score (RPS). The same evaluation was repeated at the end of the treatment period. Severity of the condition was assessed by a composite outcome score, a combination of different clinical outcome measures forming a clinical severity index. The variations between these questionnaire scores before and after treatment and the variations between the clinical severity indices estimated by clinicians were used as measures of the treatment impact. The first rationale for the validation was a positive correlation between clinical and questionnaire score changes. Another rationale for validation of the new instruments was the ability to identify the different treatment interventions. RESULTS: The correlation between the clinical severity index and the RPS was good (r = 0.62). Moreover, the RPS demonstrated a good discriminant power in detecting patients with effective treatment: it showed a specificity of 74% and a sensitivity of 75%. The PGWB correlated less well with the clinical score and was less discriminant. The specific function and symptom questionnaire showed little additional validity. CONCLUSIONS: Outcomes of syndrome severity such as pain and subjective well-being, as measured by self-reported questionnaires, can be valid instruments to evaluate treatment efficacy in short-term clinical trials. In the current study, the RPS proved to be particularly useful to assess the widespread tenderness of fibromyalgia and demonstrated high discriminative power.

Activities of Daily Living↗
PubMed2006

Brazilian-Portuguese validation of the University of Washington Quality of Life Questionnaire for patients with head and neck cancer.

BACKGROUND: The University of Washington Quality of Life (UW-QOL) questionnaire is an English-language survey instrument used worldwide to assess the quality of life of patients with head and neck cancer. To be used in other cultures, such instruments require careful translation and psychometric validation in other languages. METHODS: The translation and cultural adaptation of the questionnaire were performed following accepted international guidelines. The psychometric validation was performed on a consecutive series of patients with at least 1 year of disease-free survival after treatment for squamous cell carcinoma of the upper aerodigestive tract, recruited from October 2004 to January 2005 from a tertiary cancer center hospital. Eligible subjects were invited to complete the Portuguese version of the UW-QOL questionnaire during routine clinical consultation and complete it again within 15 days. They also completed a validated Portuguese version of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and a questionnaire to evaluate anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]). RESULTS: A Portuguese version of the questionnaire was developed in iterative fashion. In the psychometric validation process, a total of 109 patients were analyzed. Reliability was excellent, including both internal consistency (Cronbach's alpha [alpha] of 0.744) and test retest reliability (intraclass correlation coefficient [ICC] of 0.882). Construct validity was supported by statistically significant relationships between the SF-36 and HAD questionnaires and the translated UW-QOL questionnaire. CONCLUSIONS: The Brazilian-Portuguese version of the UW-QOL questionnaire appears to be culturally appropriate and psychometrically valid. This version is a valuable tool to evaluate accurately the quality of life of Brazilian patients with head and neck cancer.

Adult↗
PubMed2005

Another form to fill in! Clients' reflections on the hospice use of questionnaires.

GOALS OF WORK: The use of validated tools is increasingly accepted as an unqualified good that is viewed as best practice in supportive care. This article begins to explore the impact of standardized questionnaire use in supportive care by presenting findings from recent qualitative research on clients' perceptions of the use of standardized assessment tools during their hospice experience. PATIENTS AND METHODS: There were two arms to this phenomenological descriptive study: A. Interviews with hospice patients and their carers; B. Interviews with hospice staff. The results from arm A are reported in this article. This involved interviews with ten families (available patient and carer) who had hospice experience with questionnaires and ten families who were cared for without questionnaires. The interviews were audiorecorded, transcribed verbatim, and thematically analysed. MAIN RESULTS: The research presented in this article is seminal work in the area which affirms significant concerns about the use of questionnaires in hospice practice. The evidence indicates the majority of clients dislike the use of questionnaires and points to questionnaire use being a practice built around staff, rather than client, needs. The findings also provide insight into the process of collusion by which hospice workers who are enthusiastic about the use of questionnaires can be led to believe, because of client gratitude, that the process is positive. CONCLUSIONS: Questionnaires should not be seen as an unqualified good, and thus should not be automatically accepted as best practice within hospice or palliative care service provision.

Attitude to Death↗
PubMed2005

Patient satisfaction after surgery for trigeminal neuralgia--development of a questionnaire.

OBJECTIVE: This project aimed to prepare a self complete patient satisfaction survey for patients who have undergone surgery for trigeminal neuralgia and then assess its reproducibility, validity and acceptability in one centre. METHODS: The questionnaire, for initial use in patients who had undergone posterior fossa surgery for trigeminal neuralgia, was designed after a systematic review of the surgical literature had been performed and discussions held at the US and UK Trigeminal Neuralgia Support group meetings. It underwent several changes after input from neurosurgeons, patients, copywriter and statistician and finally contained 44 questions, the SF12, Hospital Anxiety and Depression Scale (HAD), Brief Pain Inventory (BPI) and McGill Pain questionnaire (MPQ). From the total number of 413 patients in the database of one centre the questionnaire was sent with a covering letter to 305 patients, the rest had died (25), were lost to follow up (26) or did not meet the inclusion criteria (56). One patient had bilateral PSR. The completed questionnaires were evaluated by an independent physician, neurosurgeon and patient. A repeat questionnaire was sent to 10% of the patients to check reproducibility. RESULTS: The questionnaires were well completed with a final response rate of 92%. It appeared to be highly acceptable and reproducible but needed adjustment to improve its validity before being used in other centres and for all surgical procedures. A new questionnaire is proposed which could be used on an annual basis. CONCLUSIONS: A questionnaire has been developed for use in patients who have undergone surgical management for trigeminal neuralgia and which is acceptable to patients.

Decompression, Surgical↗
PubMed2007

Optimizing the design of web-based questionnaires--experience from a population-based study among 50,000 women.

BACKGROUND: Web-questionnaires are an important tool for future epidemiological research because these allow for rapid and cost-efficient assembly of self-reported information on risk factors and health outcomes. However, to achieve high response rates it is essential to accommodate factors that prevent drop out and so insure validity of future studies. We aim to study how socio-demographic variables as well as design issues such as the ordering and level of difficulty (Easy-to-hard vs. Hard-to-easy) of questions in a web-questionnaire affects the probability of drop out and non-response. METHOD: In 2003 we invited 47,859 women participating in an ongoing prospective study to a follow-up using a web-based mode. Two versions of the questionnaire existed, varying in level of difficulty (Easy-to-hard vs. Hard-to-easy). We report drop out (proportion non-completers) between groups defined by level of difficulty and estimated adjusted risk differences. RESULTS: The drop out differs significantly depending on the order of the questions in the web-questionnaire. The socio-demographic pattern among lurkers (participants that enter, start responding to, but do not complete a web-questionnaire) differs from that among completers of web-questionnaires. CONCLUSIONS: An additional 6% units of completers--persons initiating and completing the questionnaire--can be obtained by considering the ordering of questions. A group uniquely identified in web-surveys, as lurkers are potentially easier to persuade to complete an already started web-questionnaire compared to a non-responder. Lurkers thus constitute a unique opportunity of decreasing the drop out rate and therefore merit future research.

Cohort Studies↗
PubMed2006

Validation and repeatability of a short questionnaire for dry eye syndrome.

PURPOSE: To clinically validate and ascertain the repeatability of a short questionnaire for dry eye syndrome (DES), consisting of two questions pertaining to symptoms (dryness and irritation) and one question regarding previous history of clinically diagnosed DES. DESIGN: Clinical validation study with repeated assessments. METHODS: A short questionnaire for DES was administered to participants of two large cohort studies, the Women's Health Study (WHS) and the Physicians' Health Study (PHS). A supplementary questionnaire comprising 16 questions pertaining to symptoms was mailed to a subset of 450 WHS and 240 PHS participants, selected so that a third of these subjects had DES based on their response to the short questionnaire. Repeatability of the dryness and irritation symptom questions was ascertained using intraclass correlation coefficient (ICC). Standardized ophthalmologic examination was performed on 53 subjects. Sensitivity and specificity of the short questionnaire was determined using a combination of clinical tests to define clinical DES. RESULTS: An ICC of 0.75 for dryness and 0.65 for irritation was found between subsequent measurements. Participants' responses to the dryness and irritation questions were highly correlated (r = 0.75) with a score derived from responses to the longer 16-symptom questionnaire. The short questionnaire for DES had a sensitivity of 77% and specificity of 83% when cutoff point for clinical DES was Schirmer 1 value </=10 mm or tear breakup time <10 seconds. CONCLUSION: The short questionnaire for DES is a sensitive and repeatable tool that is easy to administer in large epidemiologic research studies as well as clinical research.

Dry Eye Syndromes↗
PubMed2005

A new questionnaire for urinary incontinence diagnosis in women: development and testing.

OBJECTIVE: The purpose of this study was to develop a questionnaire for urinary incontinence diagnosis in women and to test its reliability and validity, with incontinence specialists' clinical evaluations as the gold standard. STUDY DESIGN: One hundred seventeen urogynecology outpatients with urinary incontinence symptoms completed the Questionnaire for Urinary Incontinence Diagnosis at enrollment and 1 week and 9 months later. Baseline clinical diagnoses were compared with Questionnaire for Urinary Incontinence Diagnosis diagnoses (criterion validity). Nine-month Questionnaire for Urinary Incontinence Diagnosis change scores were compared across treatment groups (responsiveness). RESULTS: Clinical diagnoses included stress (n = 15), urge (n = 26), and mixed urinary incontinence (n = 72). Internal consistency and test-retest reliability estimates were good. Sensitivity and specificity were 85% (95% CI, 75%, 91%) and 71% (95% CI, 51%, 87%), respectively, for stress urinary incontinence and 79% (95% CI, 69%, 86%) and 79% (95% CI, 54%, 94%), respectively, for urge urinary incontinence. The Questionnaire for Urinary Incontinence Diagnosis correctly diagnosed urinary incontinence type in 80% of subjects. Questionnaire for Urinary Incontinence Diagnosis Stress and Urge scores decreased significantly in treated subjects. CONCLUSION: The Questionnaire for Urinary Incontinence Diagnosis, a new 6-item questionnaire for female urinary incontinence type diagnosis, is reliable and able to diagnose stress urinary incontinence and urge urinary incontinence in a referral urogynecology patient population with accuracy.

Adult↗
PubMed2005

Validity and reliability of the Italian version of the Chronic Liver Disease Questionnaire (CLDQ-I) for the assessment of health-related quality of life.

BACKGROUND: The Chronic Liver Disease Questionnaire is a specific health-related quality of life assessment designed for patients with liver diseases. AIM: The aim of this paper is to report on the validity, reliability and sensitivity to change of the Italian version (Chronic Liver Disease Questionnaire-I) in subjects with HCV infection. SUBJECTS: The Chronic Liver Disease Questionnaire-I was administered to 350 subjects with HCV infection together with the World Health Organization Quality of Life Assessment, abbreviated version, a generic quality of life assessment. METHODS: The instrument was translated from English, backtranslated and reviewed in focus groups in the framework of a large multicentre study. Exploratory factor analysis identified five factors accounting for 65% of the variance of Chronic Liver Disease Questionnaire-I items and only partially overlapping with those found in the original version. RESULTS: The Chronic Liver Disease Questionnaire-I proved to discriminate between subjects with and without comorbid diseases at baseline (t-test = 3.59, p < 0.001). Test-retest reliability was moderate (ICC = 0.60). The Chronic Liver Disease Questionnaire-I was sensitive to change in patients who deteriorated after one month of treatment. Change in the overall Chronic Liver Disease Questionnaire-I score in deteriorated patients was correlated with changes in World Health Organization Quality of Life Assessment, abbreviated version scores in the physical, psychological and environment, but not in the social area. CONCLUSIONS: The Italian version of Chronic Liver Disease Questionnaire is a valid and reliable instrument to be used in cross-sectional and longitudinal studies.

Chronic Disease↗
PubMed2005

The Bournemouth Questionnaire: can it be used to monitor and predict treatment outcome in chiropractic patients with persistent low back pain?

OBJECTIVE: To investigate the Bournemouth Questionnaire (BQ) as a baseline, monitoring of progress, and prognostic instrument in chiropractic patients with persistent low back pain (LBP). STUDY DESIGN: Predictive and concurrent validation study. STUDY PARTICIPANTS AND SETTING: One hundred fifteen Norwegian chiropractors collected prospective data on 875 patients with persistent LBP, defined as LBP for at least 2 weeks at baseline and a minimum of 30 days totaling within the preceding year. METHODS: Data collection took place at first consultation, fourth visit, and 3 months using the BQ, the revised Oswestry questionnaire, and a 10-point pain box scale. Follow-up at 12 months included the BQ, Oswestry questionnaire, and additional questions on the number of days with LBP and the number of days off work in the past year. DATA ANALYSIS: Frequency of reporting of each 7 items in the BQ at baseline was identified as median value with 10th and 90th percentiles. Concurrent analyses of the 2 questionnaires were made at the 4 points in time with calculation of mean differences with limits of agreement together with Bland-Altman plots. Logistic regression was used to identify and compare the predictive values of the questionnaires and to test the relevance of each individual item in the BQ. RESULTS: The median baseline values of the 7 items in the BQ ranged from 2 to 5. The 2 questionnaires did not agree on patients' status, and mean differences between the Oswestry questionnaire and the BQ were largest when patients reported higher scores. The predictive values for the 2 questionnaires were low, with no significant difference between the 2. The predictive value of the BQ could be improved by removing most of the 7 items. Certain items can predict specific outcomes. CONCLUSIONS: The BQ is not a useful instrument to identify baseline status, monitor progress, or predict the 1-year progress in chiropractic patients having persistent LBP. However, certain individual items are useful to predict specific outcomes.

Absenteeism↗