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PubMed2006

[Cross-cultural adaptation of health-related quality of life questionnaire: English version of Qualiveen abstract].

INTRODUCTION: The Qualiveen questionnaire is a urinary disorder-specific health-related quality of life (HRQL) instrument. Developed in French, the instrument's translation into English was the first step of a process leading to an HRQL questionnaire that can be used in a different culture. However, the cultural adaptation of an HRQL questionnaire is achieved only when the psychometric properties of the translated questionnaire are documented. AIM: To develop an equivalent English version of the Qualiveen questionnaire and to assess its discriminative measurement properties. METHODS: Fifty-five Canadian out-patients with multiple sclerosis (MS) completed a set of questionnaires, including the Qualiveen; the MS Quality Of Life-54 (MSQOL-54), an MS-specific HRQL questionnaire; urinary function assessment; and the expanded disability status scale (EDSS) twice at an interval of 2 to 4 weeks. RESULTS: The English Qualiveen proved to be test-retest reliable (intraclass correlation coefficient=0.94). Consistent with a priori predictions, we found a strong association between overall Qualiveen score and degree of incontinence (0.63), a moderate association with type of urinary symptoms (0.49), a weak association with manner of voiding (0.28) and weak or absent associations with MSQOL-54, EDSS bladder/bowel and global EDSS domains. Predictions proved to be generally accurate (weighted kappa=0.65). CONCLUSION: The test-retest reliability and cross-sectional construct validity of the English version of Qualiveen are excellent and similar to the original French version. Further studies should explore Qualiveen's longitudinal validity and responsiveness.

Cross-Sectional Studies↗
PubMed2004

A comparison of 4 questionnaires to measure fatigue in postpoliomyelitis syndrome.

OBJECTIVE: To assess the comparability and reproducibility of 4 questionnaires used to measure fatigue in postpoliomyelitis syndrome (PPS). DESIGN: Repeated-measures at a 3-week interval. SETTING: University hospital. PARTICIPANTS: Convenience sample of 65 patients with PPS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Fatigue Severity Scale (FSS), the Nottingham Health Profile (NHP) energy category, the Polio Problem List (PPL) fatigue item, and the Dutch Short Fatigue Questionnaire (SFQ). RESULTS: Correlations of scores between questionnaires were all significant (P<.01) and ranged from.43 (between the NHP energy category and the PPL fatigue item) to.68 (between the PPL fatigue item and the SFQ). Scores on the second visit, normalized to a 0 to 100 scale, were: FSS, 78+/-15; NHP energy category, 47+/-35; PPL fatigue item, 81+/-17; and SFQ, 65+/-22. Except for the difference between the FSS and the PPL fatigue item, the differences in scores between the questionnaires were significant (P<.01). Scale analysis indicated that all questionnaires measured the same unidimensional construct. The reproducibility of the FSS, the PPL fatigue item, and the SFQ was moderate. The smallest detectable change was 1.5 points for the FSS, 2.0 points for the PPL fatigue item, and 1.9 points for the SFQ. CONCLUSIONS: Although the questionnaires measure the same fatigue construct in PPS, the results are not interchangeable because the ranges of measurement differ. The NHP energy category, in particular, appeared to have a high detection threshold. The moderate reproducibility of the questionnaires indicates a lack of precision, especially when applied at the individual patient level.

Adult↗
PubMed2005

A rapid self-administered food frequency questionnaire for the evaluation of dietary protein intake.

BACKGROUND: Dietary calcium and proteins are important determinants of bone health. Among the various methods to evaluate dietary intakes, food frequency questionnaires provide a self-administered, quick and simple estimation of dietary intakes. OBJECTIVES: To validate a simple, rapid, self-administered food frequency questionnaire for the estimation of dietary protein intake. DESIGN AND METHODS: A self-administrable food frequency questionnaire comprising 20 items was developed. The accuracy of dietary protein evaluation by this questionnaire was verified by comparing it to the results of a diary performed over a 4-day-period in 29 normal healthy subjects (mean age+/-SD, 40.1+/-12.3), and to the mean of three last 24-h recalls, administered at 6-week intervals in 43 healthy men (mean age+/-SD, 51.2+/-5.1). RESULTS: As compared with the values from both reference methods, the slope coefficient of linear regression analysis was statistically different from zero, but the percent of variance explained by the frequency questionnaire results amounted to 35% (diary) and 18% (24-h recall), respectively. Bland and Altman graphs as well as the Pitman's test did not show any difference in variability between the reference methods and the new food frequency questionnaire. This indicates a reliable estimate of group average dietary protein intakes. CONCLUSION: This rapid, self-administered food frequency questionnaire could be a useful tool for the evaluation of dietary protein intakes in groups of subjects.

Adult↗
PubMed2004

Evaluation of the performance and concordance of clinical questionnaires for the diagnosis of heart failure in primary care.

AIM: To validate and estimate the performance statistics and concordance of seven clinical questionnaires for the diagnosis of chronic heart failure (HF). METHODS: Community-based epidemiological survey of patients aged >25 years attending a random sample of primary health care centers in Portugal. Heart failure was identified according to the Guidelines of the European Society of Cardiology (ESC). RESULTS: A total of 5434 subjects evaluated by 365 investigators were eligible for analysis, 551 of which had criteria for heart failure. Overall, the questionnaires had high specificity, usually above 90%, but low sensitivity, providing an increase in the likelihood of heart failure from 4.3% pre-test to 25-35% post-test in most cases. The Göteborg questionnaire was the most balanced regarding sensitivity (84%) and specificity (81%) but this may reflect its use of prescription of digoxin or diuretics as diagnostic criteria for diagnosis. The Walma, Framingham and NHANES-I questionnaires performed similarly (Sensitivity: 63%, Specificity: 93%), while the Boston and the Gheorghiade questionnaires had a somewhat lower sensitivity (55%). Concordance was good between the Boston, Framingham, Gheorghiade, NHANES-I and Walma questionnaires. CONCLUSIONS: This study evaluated seven clinical questionnaires for the diagnosis of heart failure in the community. Their low sensitivity impairs their usefulness as diagnostic instruments, but their high specificity makes them useful for the identification of patients with fluid retention and/or exercise intolerance from non-cardiac causes.

Adult↗
PubMed2006

Validity and reliability of a questionnaire for evaluating nocturia, nocturnal enuresis and sleep-interruptions in an elderly population.

OBJECTIVES: To validate a new questionnaire evaluating nocturia, nocturnal enuresis and sleep-interruptions in an elderly population of men and women in Denmark. METHODS: The Nocturia, Nocturnal Enuresis and Sleep-interruption Questionnaire (NNES-Q) emerged from review of the literature and expert consensus. The questionnaire was a subset of a larger questionnaire comprising several domains on health status and voiding. Convergent and discriminatory validity was assessed in an unselected population of 2000 men and 2000 women 60-80 years old. To test reproducibility, 400 respondents were mailed a separate questionnaire 2 weeks apart. A subgroup of men and women with and without nocturia was used for evaluating reliability of number of nocturia episodes. RESULTS: A total of 2825 (70.6%) filled in the questionnaire. A decrease in health status was correlated with increasing bother (range: -0.25 to -0.36, p<0.001, Spearman's r). These findings indicate acceptable convergent validity. Significant discriminatory validity was proven in separate groups of symptom severity (p<0.0001, Kruskal-Wallis test). Median kappa was 0.70 (range 0.58-0.86) indicating substantial agreement in the retest analysis. Number of nocturia episodes in questionnaires correlated with frequency volume charts (Spearman's rho 0.88; p<0.001). CONCLUSION: These data support that the NNES-Q has a good discriminatory and convergent validity, and is reliable over time. The NNES-Q may be useful in epidemiological studies and may also have a potential in daily clinical work up in patients with nocturia and nocturnal enuresis.

Aged↗
PubMed2006

Design and validation of a new screening instrument for lower urinary tract dysfunction: the bladder control self-assessment questionnaire (B-SAQ).

OBJECTIVES: To develop and validate a short patient self-assessment screening questionnaire: bladder control self-assessment questionnaire (B-SAQ) for the evaluation of lower urinary tract symptoms. This first validation study was undertaken amongst women. PATIENTS AND METHODS: Three hundred twenty-nine women attending general gynaecology and urogynaecology clinics completed both the B-SAQ and Kings Health questionnaire prior to medical consultation, and independent physician assessment of the presence of lower urinary tract symptoms (LUTS) and need for treatment. The psychometric properties of the B-SAQ were subsequently analysed. RESULTS: The B-SAQ was quick and easy to complete, with 89% of respondents completing all items correctly in less than 5 min. The internal consistency (Cronbach's alpha score 0.90-0.91), criterion validity (Pearson's correlation values of 0.79 and 0.81, p<0.0001 with the incontinence impact domain of the Kings Health questionnaire), and test-retest reliability of the questionnaire were good. The sensitivity and specificity of the questionnaire to identify patients with bothersome LUTS was 98% and 79%, respectively. CONCLUSIONS: LUTS are commonly underreported. Empowering patients to self-assess their bladder symptoms and the need for treatment will improve treatment-seeking behaviour. The B-SAQ is a psychometrically robust, short screening questionnaire that offers patients the ability to assess their bladder symptoms and the bother they cause, and the potential benefit of seeking medical help.

Adolescent↗
PubMed2005

Hypopituitary patients prefer a touch-screen to paper quality of life questionnaire.

UNLABELLED: Health Related Quality of Life questionnaires are frequently used for research, however only recently has their use been recommended in the routine clinical management of pituitary patients. Questionnaires frequently have complex scoring systems, and may be cumbersome, limiting widespread application. Touch-screen technology can overcome these limitations. We have developed a touch-screen 'Questions on Life Satisfaction-Hypopituitarism' QLS-H (Flash 5 Action script, program design by IG) questionnaire and compared its use and accuracy with a paper version questionnaire in 50 pituitary patients who were attending routine clinics. The HRQoL Z-score for the patient group was lower than the average for the normal UK population, as might be predicted for this patient group. There was no statistically significant difference between scores obtained by the touch-screen and paper questionnaires; mean (SD) Z score was -1.33 (1.4) for touch-screen and -1.26 (1.5) for paper. The touch-screen was preferred by 80% of patients, and quicker to complete (<5min). Additionally, there were significant errors in 14 (28%) of manually scored paper questionnaires. IN CONCLUSION: Touch-screen QLS-H questionnaires have advantages over the paper version for the routine clinical assessment of patients with hypopituitarism.

Adult↗
PubMed2005

Internet-administered adolescent health questionnaires compared with a paper version in a randomized study.

PURPOSE: To assess whether the scores of an Internet-administered adolescent health questionnaire (using two different interfaces) are equivalent to those obtained via paper and pencil (P&P). Furthermore, it compares adolescents' evaluations of modes of administration. METHODS: We randomly assigned 591 adolescents (aged 13-17 years) from five secondary schools within their classes to one of the two Internet interfaces (multiple items vs. one item per screen) or P&P. Adolescents completed questionnaires on psychosocial well-being (KIVPA), self-reported problems, health care utilization, and health-related behavior and supplementary evaluation surveys (on the given health questionnaire mode) in the computer classrooms. Differences in questionnaire scores among administration modes were analyzed by the Student's t-test and Wald test. RESULTS: Response rate was 96% (n = 565). Adolescents in the Internet one-item mode more frequently reported satisfaction with appearance compared with the Internet multiple-items mode (p </= .01). The Internet group had more adolescents reporting that they have a sufficient number of friends than those in the paper mode (p </= .01). The Internet mode received more favorable evaluations than P&P. The multiple items per screen format was favored over the one item per screen format on perceived speed of the administration mode. CONCLUSIONS: Health questionnaires via Internet were positively evaluated and generally resulted in equal scores of health status/health behavior compared with the P&P mode. We recommend further research with other questionnaires, and in other settings as well with regard to score equivalence between web-based and P&P-administered questionnaires.

Adolescent↗
PubMed2006

Enclosing a pen with a postal questionnaire can significantly increase the response rate.

BACKGROUND AND OBJECTIVES: It is important to maximize response rates to postal questionnaires. We compared the impact of three low-cost interventions on response rates. METHODS: A 2 x 2 x 2 factorial trial was conducted, nested within TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears). Three interventions were evaluated: (1) enclosing a TOMBOLA-branded pen with the questionnaire (as opposed to no pen); (2) sending the questionnaires by first class post (as opposed to second class); and (3) enclosing a preaddressed return envelope on which there was a second class postage stamp (rather than a freepost business-reply envelope). Nine hundred thirty women, aged 20-59 years, due to receive a TOMBOLA psychosocial questionnaire by post during June-August 2003 were randomized. RESULTS: Enclosing a pen resulted in a statistically significant 7.0% increase in the cumulative proportion of questionnaires returned (from 61.5 to 68.5%; P = .002). The adjusted odds of response was significantly raised (odds ratio [OR] = 1.38, 95% confidence interval [CI] 1.04-1.82). Neither first class post nor providing a stamped envelope had a significant impact on response. There were no interactions between the interventions. CONCLUSIONS: Enclosing a pen with a questionnaire can significantly increase response. This low-cost strategy was effective against a background of "good practice" with regard to the administration of postal questionnaires.

Adult↗
PubMed1995

Validation of a food habits questionnaire: poor performance in male manual laborers.

OBJECT: To examine the reliability and validity of a food habits questionnaire developed by Kristal et al in male manual laborers. DESIGN: A cross-sectional baseline survey. SETTING: The community of Ottawa-Carleton, Canada. SUBJECTS: All people working in non-office-based positions for two local governments were invited to a heart-health screening clinic. Male subjects (n = 362) who met risk factor eligibility criteria were interviewed and entered into the study. MAIN OUTCOME MEASURES: The food habits questionnaire developed by Kristal et al was the main focus of analysis. Additional outcomes included a food frequency questionnaire and risk factors for cardiovascular disease. STATISTICAL ANALYSES: Reliability was assessed using Cronbach's alpha and Pearson correlation coefficients; confirmatory factor analysis was also done. Validity assessment included partial correlations. RESULTS: Low internal consistency was found for the five subscales of the questionnaire (alpha = .13 to .53). Confirmatory factor analysis did not reveal the postulated five-factor (subscale) structure. Correlation of the subscale scores with dietary fat intake was low (r = -.09 to -.23), and none of these associations were statistically significant after adjustment for age, body mass index, and education. An alternative scoring system that treated the questionnaire as a unidimensional behavioral checklist produced a higher internal consistency (alpha = .70) and significant correlation with dietary fat intake (r = -.27). CONCLUSIONS: The psychometric properties and scoring of the food habits questionnaire need to be explored in additional populations before the questionnaire is adopted for general use.

Adult↗
PubMed2003

A self-administered health questionnaire for the preoperative risk stratification of patients undergoing cataract surgery.

PURPOSE: To determine if a self-administered health status questionnaire completed by candidates for cataract surgery is beneficial for identifying medical comorbidities and patients at risk for adverse intraoperative and postoperative medical events. DESIGN: Prospective cohort study. METHODS: Data were obtained from a large, randomized clinical trial of 19,250 cataract surgeries performed between June 1, 1995, and June 30, 1997. Preoperative data were obtained from a standardized, self-administered patient health questionnaire and a history and physical form completed by the patient's physician. A record of adverse medical events on the day of surgery and through the first 7 postoperative days was recorded. RESULTS: Responses to 21 questions on the questionnaire were highly specific for 12 comorbid conditions identified by the physician history and physical, ranging from 100% specificity for arrhythmia to 91.3% specificity for coronary artery disease. Comorbid conditions identified by the questionnaire were associated with similar relative risks of adverse events as those identified by the physician history and physical. Patients who had no comorbidities identified by the questionnaire had adverse medical event rates indistinguishable from patients with no comorbid conditions identified by the health provider history and physical. CONCLUSIONS: The self-administered questionnaire showed a high degree of specificity for 12 common comorbid conditions in cataract patients. A questionnaire such as this may be useful in preoperative risk stratification.

Aged↗
PubMed2002

Assessment of eating disorders: comparison of interview and questionnaire data from a long-term follow-up study of bulimia nervosa.

OBJECTIVE: This paper examines diagnostic agreement between interview and questionnaire assessments of women participating in a long-term follow-up study of bulimia nervosa. METHODS: Women (N = 162) completed follow-up evaluations comprising questionnaires and either face-to-face or telephone interviews. RESULTS: Consistent with previous research, rates of eating disorders were higher when assessed by questionnaire than when assessed by interview; however, rates of full bulimia nervosa were similar. Overall diagnostic agreement was adequate for eating disorders (kappa=.64) but poor for bulimia nervosa (kappa=.49), with greater agreement between questionnaires and telephone interviews (kappa's range: .67-.71) than between questionnaires and face-to-face interviews (kappa's range: .35-.58). CONCLUSION: Findings support the possibility that increased rates of eating pathology on questionnaire assessments may be due, in part, to increased candor when participants feel more anonymous. Questionnaire assessments may not be inferior to interview assessments; they may reveal different aspects of disordered eating.

Adult↗
PubMedDate not supplied

Diagnosis of schistosomiasis japonica in Chinese schoolchildren by administration of a questionnaire.

This paper describes a rapid, simple, cost-effective questionnaire for screening school-aged children at risk for Asian schistosomiasis in China. Five hundred and thirty-two children, aged 8-14 years, were selected from 3 schools in an area moderately endemic for Schistosoma japonicum in Hunan province. The questionnaire, comprising 15 multiple-choice questions, was administered by teachers in order to collect both ethnographic and epidemiological data relevant to current S. japonicum infections. This was followed by Kato-Katz thick smear stool examinations, miracidium hatching tests, and soluble egg antigen-enzyme linked immunosorbent assays in order to validate the efficacy of the questionnaire approach. The results from a combination of all 3 procedures indicated that the overall schistosomiasis prevalence in the 3 schools was 29.9% (138/472). Six risk factors (episodes of diarrhoea, frequency of water contact, school grade attained, weakness, past history of S. japonicum infection(s), and whether a subject had been previously treated for schistosomiasis) in the questionnaire were determined by logistic regression to be highly statistically significant predictors of individual current infection. The sensitivity (93.7%), specificity (91.9%) and low cost (c. US$ 0.6/true positive case) associated with the 6 variables model make the questionnaire approach a very useful diagnostic tool for screening marshland and lake communities at high risk for schistosomiasis in China before selective treatment with praziquantel or diagnostic follow-up. An even simpler 3 variables 'yes/no' model was derived from the questionnaire and found to be nearly as good at predicting individual infection (sensitivity 86.2% and specificity exceeding 97.6%) and extremely simple to use. If validated in other ecological settings in China the questionnaire, modified or as presented here, could be adopted by the national schistosomiasis control programme.

Adolescent↗
PubMed1995

Does the mode of questionnaire administration affect the reporting of urinary symptoms?

OBJECTIVES: To assess the effect of modes of administration (self-administered questionnaires, oral face-to-face interview, and telephone interview) on responses to the American Urological Association Symptom Index (AUASI) in randomly selected community men. METHODS: An age-stratified random sample of 475 white male residents of Olmsted County, Minnesota, aged 40 to 79 years, without prior prostate surgery or prostate cancer were queried about urinary symptom frequency twice at baseline and twice approximately 2 years later using questions with wording similar to the AUASI: At baseline and first follow-up, questionnaires were self-administered initially, followed by a structured interview by a female urology nurse within 2 to 28 weeks. A subset of 200 randomly selected men received a telephone interview by a female research assistant following the self-administered questionnaire given at a second follow-up approximately 4 years after baseline. RESULTS: Mean symptom scores obtained by oral interview were 1 to 2 points lower than those from self-administered questionnaires (P < 0.01). In a random subset (n = 200) interviewed by telephone, mean AUASI scores were as much as 4 points lower than those from self-completed questionnaires. CONCLUSIONS: Values of the AUASI obtained by interviewer administration may be lower than those obtained by self-administered questionnaires. When assessment of change in urinary symptoms over time is of interest, the same standardized method of questionnaire administration should be used at baseline and follow-up evaluations to avoid introducing artifactual differences related to the mode of administration.

Adult↗
PubMedDate not supplied

[Evaluation of the quality of the websites of pharmacoeconomics and health economics centers through a validated questionnaire].

OBJECTIVES: To evaluate the quality of websites of pharmacoeconomics centers and organizations in the countries of the European Union, the United States and Canada through a validated system with explicit criteria. METHODS: The websites of institutions and centers related to pharmacoeconomics and health economics in the 24 countries of the Organization for Economic Cooperation and Development (OECD) were identified through browsers. Twenty-four predetermined key words were used. A questionnaire on the quality of the information on health was designed and validated according to standards established in literature. Using this questionnaire, we evaluated the quality of the pharmacoeconomics and health economics centers. RESULTS: In 23 of the 26 items of the validated questionnaire, Cochran's Q was statistically significant. The coefficient of reliability obtained in the questionnaire was 0.90 and the value obtained in Pearson's correlation was 0.812. The 33 pharmacoeconomics and health economics centers evaluated were divided into three subgroups according to the scores obtained on the questionnaire: centers of high quality, average quality (the majority), and low quality. The centers in the high-quality subgroup were: the Leonard Davis Institute of Health Economics, the Centre for Health Economics, the Agency for Healthcare Research and Quality, the Health Economics Research Unit, the Institute of Health Economics and the Health Economics Resource Center. CONCLUSIONS: The criteria included in the questionnaire used to evaluate the quality of websites on health were: credibility, content, description, links, design, interactivity and safeguards. The quality of the websites of centers related to pharmacoeconomics and health economics analyzed in this study using the criteria established in the questionnaire varied from 30.4% to 79.8%. A validated system with explicit criteria is required to evaluate the quality of information on health available on the Internet.

Economics, Medical↗
PubMed2003

A clinical questionnaire for the diagnosis of carpal tunnel syndrome.

This prospective study compared the sensitivities of a scored questionnaire and electrophysiological examination in the diagnosis of carpal tunnel syndrome. Patients were assessed by a hand surgeon using a scored questionnaire, and then underwent an electrophysiological assessment by an experienced neurophysiologist (blinded to the questionnaire results). Patients diagnosed as having carpal tunnel syndrome by either the questionnaire, the electrophysiological examination or both underwent decompression. Symptom relief was taken as the "gold standard" for true carpal tunnel syndrome. The results showed a sensitivity of 85% for the scored questionnaire and 92% for nerve conduction studies with a positive predictive value of 90% for the scored questionnaire and 92% for nerve conduction studies. The authors recommend that a scored questionnaire can replace nerve conduction studies in the initial assessment of whether patients presenting with dysaesthesiae in the fingers should undergo surgery. This will give major time, personnel and cost benefits.

Carpal Tunnel Syndrome↗
PubMed2003

[Reliability of a questionnaire on smoking to evaluate prevalence, knowledge and attitudes of medical students].

OBJECTIVE: To evaluate the reliability and reproducibility of results obtained from a questionnaire on the smoking habits of medical students. METHOD: A questionnaire with 30 variables was designed to measure three main parameters: prevalence, knowledge and attitudes toward smoking. First-year medical students at the University of Zaragoza (1997-98 academic year) were asked to fill in the questionnaire, and a code was assigned to each individual respondent. A test-retest method was then used to assess reliability: the same questionnaire was answered by the subjects after a period of time had elapsed. The Kappa coefficient was calculated to measure agreement. RESULTS: The questionnaire was filled in by 181 students at registration and 7 weeks later by 43 students. The first- and second-time questionnaires for 35 individuals were matched by codes. Reliability was good for most variables related to the main characteristics of smoking (such as prevalence, number of cigarettes smoked daily and consonance-dissonance). Reliability was acceptable for most variables related to knowledge but was low for 3 items. Reliability was acceptable for half the items related to attitudes and low for half. CONCLUSIONS: The questionnaire has a generally good level of reliability, with regard to reproducibility, or the likelihood that an individual will respond to an item in the same way at two different times. Some variables that measure attitudes toward smoking, however, are less reliable. Results obtained for those items should therefore be interpreted cautiously.

Adult↗
PubMed2003

Does questionnaire structure influence response in postal surveys?

This study tested the effect of questionnaire structure on response, speed of return, and content of answers in a postal survey. All 259 patients aged 30-59 years who consulted with back pain at four UK general practices from March to June 2001 were randomly allocated to receive either a traditionally or chronologically structured self-completion questionnaire. The response was higher and the returns quicker (P =.05) for the chronologic questionnaire. There were no statistically significant differences in completion rates or scores on the SF-36, Chronic Pain Grade, Hospital Anxiety and Depression Scale, or Roland-Morris Disability Questionnaire between the two types of questionnaire, and test-retest reliability was high for all scales. Changing questionnaire structure to make questions chronologic does not substantially affect the answers given, but may make a questionnaire more acceptable and easier to complete and speed up returns.

Adult↗