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PubMed2004

Questionnaire for usability evaluation of orthopaedic shoes: construction and reliability in patients with degenerative disorders of the foot.

OBJECTIVE: To develop a self-report questionnaire for patients with degenerative disorders of the foot to evaluate the usability of their orthopaedic shoes, and to assess the reproducibility and responsiveness of the instrument. DESIGN: Development of the Questionnaire for Usability Evaluation of orthopaedic shoes was based on a literature search, structured expert interviews and a ranking procedure. A cross-sectional study was carried out to determine the reproducibility and internal consistency of the questionnaire. SETTING AND SUBJECTS: The study population comprised 15 patients with degenerative disorders of the foot, who had worn their orthopaedic shoes for at least 3 years and 15 patients with degenerative disorders of the foot, who had never worn orthopaedic shoes, but would receive them within 1 month. RESULTS: Within the questionnaire 4 effectiveness items (pain, instability, callus, wounds), 1 efficiency item (putting on and taking off shoes) and 7 satisfaction items (pinch, slip, weight of shoes, cold feet, perspiration, maintenance, cosmetic appearance) were developed. All items in the questionnaire met the test-retest criteria. The smallest real difference ranged from 0.23 to 3.82 cm on a Visual Analogue Scale (10 cm). Cronbach's alpha's for the domains of pain and instability ranged from 0.70 to 0.92. CONCLUSION: The Questionnaire for Usability Evaluation should provide a good rationale to assess the usability of orthopaedic shoes and can be considered reliable.

Aged↗
PubMed2004

The effectiveness of a modified version of the Wilkinson questionnaire in screening for TIA and minor stroke in the United Kingdom.

BACKGROUND: Transient ischaemic attacks (TIAs) and minor strokes are important to diagnose as there are effective secondary preventive interventions. Significant under-reporting by patients occurs, but general practitioners tend to over-diagnose the condition, contributing in part to long clinic waiting lists. An accurate screening test could address both these problems. METHODS: A modified version of a questionnaire designed to detect TIA was tested against the gold standard of specialist diagnosis in two vascular outpatient clinics in Leicester, UK. RESULTS: The questionnaire was sent by post with the clinic appointment and completed by 136 participants. In 99 cases the same questionnaire was administered by a clinic nurse. Overall levels of agreement (kappa, 95% CI) with specialist diagnosis of TIA, stroke or neither were 0.32 (0.15, 0.48) and 0.31 (0.12, 0.50) for postal and administered questionnaires, respectively. When the diagnoses of TIA and stroke were combined, agreement rose to 0.38 (0.23, 0.53) for postal and 0.38 (0.20, 0.57) for administered versions. For this outcome, the postal version had a sensitivity of 0.56 (0.43, 0.68) and specificity of 0.81 (0.71, 0.90). Equivalent figures for administered questionnaires were 0.61 (0.46, 0.76) and 0.76 (0.63, 0.87). CONCLUSION: The questionnaire has potential in prioritising outpatient referrals but is not sufficiently specific to be used for research or population screening.

Aged↗
PubMed1999

Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods.

BACKGROUND: The validation of dietary assessment instruments is critical in the evaluation of diet as a chronic disease risk factor. OBJECTIVE: The objective was to assess the validity of a self-administered food-frequency questionnaire by comparison with dietary recall, urinary nitrogen excretion, and total energy expenditure data. DESIGN: Over a 1-y period, data from twelve 24-h dietary recalls, a food-frequency questionnaire, and four 24-h urine samples were obtained from 134 study participants of the European Prospective Investigation into Cancer and Nutrition (EPIC) Study in Potsdam, Germany. In a substudy of 28 participants, total energy expenditure from doubly labeled water measurements was assessed. RESULTS: Energy-adjusted, deattenuated correlation coefficients between the questionnaire and the recalls ranged from 0.54 for dietary fiber to 0.86 for alcohol. Cross-classification of quintiles of nutrient intakes from the questionnaire and recalls indicated severe misclassification to be <4%. Reported protein intake correlated with estimated protein excretion (r = 0.46). Energy intake and total energy expenditure were also significantly correlated (r = 0.48); however, all but one subject underreported their energy intake. The magnitude of underreporting varied considerably, by 22% on average, and increased slightly with increasing energy intake. A similar pattern of underreporting was observed when energy intakes from the 24-h dietary recalls were compared with total energy expenditure. CONCLUSIONS: These data indicate an acceptable relative validity of the food-frequency questionnaire in this study population. Compared with measurements of total energy expenditure and protein excretion, however, only moderate agreement with both the food-frequency questionnaire and the 24-h dietary recalls was observed.

Adult↗
PubMed2003

Assessment of anticonvulsant effectiveness and safety in patients with Angelman's syndrome using an Internet questionnaire.

An Internet questionnaire was used to collect data from caregivers about seizure activities and drug therapies of patients with Angelman's syndrome (AS). A questionnaire to collect data on AS patient demographics, seizure types, laboratory diagnosis, and past history of anticonvulsant use was developed and distributed among the membership of multiple AS groups primarily through the Internet. Caregivers of AS patients were asked to rate each drug listed on the questionnaire for its effect on the patient's behavior and alertness and on the severity and frequency of the patient's seizures. A 6-point rating scale was used, with the lowest score representing the most favorable effect. Primary considerations of the survey were to reach as many people as possible, anonymously and quickly, in a widely comprehensible format. Data were collected between March 22 and October 9, 2002. Of the 88 complete questionnaires received, 75 were electronic and 13 were handwritten responses. Forty-seven percent of respondents reported patients' use of a combination of medications at some point, with 59 different combinations described, 21 of which consisted of three or more medications. The most commonly reported regimens were valproic acid and clonazepam, valproic acid and topiramate (with or without clonazepam), valproic acid and lamotrigine, and phenytoin and carbamazepine. Patient characteristics and seizure types were consistent with those of AS patients described in the literature. Topiramate and ethosuximide were rated favorably, consistent with previously published reports. Responses to the questionnaire were widespread and rapid, with 42 responses collected in the first week. An Internet questionnaire helped collect self-reported efficacy information from caregivers of AS patients.

Adolescent↗
PubMed1999

Do postal questionnaires change GPs' workload and referral patterns?

OBJECTIVE: We aimed to determine changes in workload in general practice associated with the postal administration of a health needs questionnaire. METHOD: We carried out controlled before-and-after intervention study of the effects of delivering a postal questionnaire to assess needs for care for patients with arthropathies of the hip and knee, groin hernia and varicose veins, and to assess health service utilization, general health status and risk factors for cardiovascular disease. The setting was a seven-partner, fundholding, group practice in Avon. The subjects were patients registered with an NHS group practice situated in Backwell and Nailsea, Avon. The outcome measures were the frequency of consultation, home visits and night visits, reasons for consultation, referral to specialist agencies and patterns of prescribing. RESULTS: There was no significant difference between the study and control group in the year before and the year after the postal administration of the questionnaire with respect to changes in overall frequency of consultation, frequency of referral (including type of referral) and frequency of prescribing of non-steroidal anti-inflammatory drugs. In the study group there was a significant (P<0.05) reduction in the number of daytime home visits and prescriptions written for analgesics. Analysis of the records of those who had received a medical examination, in addition to a postal questionnaire, showed that there was no significant difference between the study and control group with respect to frequency of consultation, referral to outside agencies or items prescribed. CONCLUSION: Administration of a health needs questionnaire to patients registered with this general practice was not associated with an increase in consultation frequency or referral, or a change in prescribing patterns. No plausible explanation could be identified for the significant reduction in the number of home visits and prescriptions written for analgesics. It was concluded that these results were a statistical artefact. On the basis of the evidence from this study, GPs can be reassured that the administration of health needs questionnaires of the type used in this study will not result in any increase in workload or costs of care incurred by increased referrals to outside agencies or increased prescribing.

Adult↗
PubMed2001

A new, brief questionnaire (PEQ) developed in primary health care for measuring patients' experience of interaction, emotion and consultation outcome.

BACKGROUND: A deepened understanding of patients' perspectives is essential in order to improve medical communication. By changing focus from patient satisfaction to patient experiences, more immediate, personal and affective responses may be captured. OBJECTIVE: Our aim was to develop a new consultation-specific questionnaire on patient experiences. METHODS: The questionnaire was developed in Norwegian primary care in three main phases. Phase 1: focus groups with patients in order to identify important aspects of patients' experiences, and their words and language when describing such experiences. Phase 2: a questionnaire survey with 110 items including 660 patients. Extensive testing resulted in a reduction to 25 items on six dimensions. Phase 3: a questionnaire survey with 25 items including 1092 patients. Psychometric analyses and feedback from patients and physicians involved dimensionality and tests of validity and reliability. RESULTS: A final questionnaire was produced with 18 items on five dimensions: communication; emotions; short-term outcome; barriers; and relations with the auxiliary staff. The validity and reliability estimates were highly satisfactory. Three scales were skewed while two were more equally distributed. Forty-eight per cent of the patients described less than optimal communication experiences; some communication barriers were detected in 70% of the visits and less helpful experiences with the staff were reported in 55% of the visits. Twenty-four per cent of patients left with no positive feelings, and 48% scored low on the outcome scale (knowledge, perceived result). CONCLUSIONS: The patient experience questionnaire (PEQ) emphasizes what patients value the most, i.e. interaction, emotions and outcome, and may represent a valuable tool for doctors who want feedback from their patients on the function of their doctor-patient relationships.

Adolescent↗
PubMed2004

The Polycystic Ovary Syndrome Health-Related Quality of Life Questionnaire (PCOSQ): a validation.

BACKGROUND: We wished to evaluate the psychometric properties of the Polycystic Ovary Syndrome Questionnaire (PCOSQ), a questionnaire developed to measure the health-related quality of life (HRQoL) of women with polycystic ovary syndrome. METHOD: To assess reliability and validity, women recruited from an outpatient gynaecology clinic at the Jessop Wing, Royal Hallamshire Hospital, Sheffield completed two copies of the PCOSQ and the Short Form-36 (SF-36). Secondary factor analysis was carried out to verify the composition of the dimensions. Semi-structured interviews were conducted to assess face validity. RESULTS: Of the 92 women who consented, 82 women (89%) returned questionnaires at time 1, and 69 women (75%) returned questionnaires at time 2. All five PCOSQ dimensions were internally reliable with Cronbach's alpha scores ranging from 0.70 to 0.97. Intra-class correlation coefficients to evaluate test-retest reliability were high (range 0.89-0.95, P < 0.001). Construct validity was demonstrated by high correlations for all comparisons of similar scales of the SF-36 and PCOSQ (0.49 and 0.54). Acne was identified as an important area of HRQoL missing from the questionnaire. CONCLUSIONS: The PCOSQ is a reliable instrument for measuring the HRQoL in women with PCOS. However, the validity of the questionnaire needs to be improved by incorporating a dimension on acne into the instrument.

Acne Vulgaris↗
PubMed1991

Development of a semiquantitative food frequency questionnaire to assess food, energy and nutrient intake in Denmark.

Foods to be included in a Danish self-administered semiquantitative food frequency questionnaire were identified from food tables developed, together with data collected, for the survey 'Dietary habits in Denmark, 1985'. The questionnaire was to be used in a prospective study on diet, cancer and health, and the aim was to rank individuals with regard to intake of 19 different nutrients considered of prime importance in human carcinogenesis. The questionnaire for the dietary survey included 247 foods and recipes. From stepwise multiple regression analyses with the intake of each of the 19 nutrients as the dependent variable and the intake of the 247 foods and recipes as independent variables, the foods in the models explaining 90% of the between-person variability were considered for the final questionnaire. All relevant analyses were performed for the study group as a whole, for men and women separately, and in each gender for subgroups of energy intake. Taken together, the models explaining 90% of the between-person variability identified a total of 74 foods or recipes, which were important predictors of the intake of one or more of the nutrients considered. A few foods were excluded and a few foods were added to the final questionnaire based on common biological background information, and on information on foods providing important amounts of given nutrients, but which failed to contribute to regression analyses. The 92 foods and recipes, which were included in the final questionnaire provided altogether 81% of the average total supply of the nutrients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Validity and reliability of a questionnaire on fecundability.

The validity of a short questionnaire on fertility problems was tested on a group of 151 moderately educated women who had participated in a prospective study on early pregnancy failure some years before. Part of this group was approached by a personal interview, another part by telephone interviews and a third part was sent a questionnaire by mail. Reliability was tested on another population of 89 women with at least one child. The questionnaire was presented to these women twice with an interval of 3-5 weeks. The validity study showed no systematic errors for either of the approaches. Random errors were fairly large except for the personal interviews. The reliability showed great stability for the telephone interviews as well as for the mailed questionnaire. It is concluded that the questionnaire performs reasonably well, but on some items the draft questionnaire should be rephrased. The choice of a specific approach to the study population depends on the research question.

Adult↗
PubMed1993

Development and validation of a food frequency questionnaire in Spain.

To create a suitable instrument to estimate intakes of total calories, protein, carbohydrate, fats (saturated, mono and polyunsaturated), alcohol, cholesterol, fibre, vitamin A and vitamin C in epidemiological studies conducted in Spain, a food frequency questionnaire was developed and tested. In particular, the questionnaire was designed to be used in a large population-based case-control study of dietary factors in relation to breast and colorectal cancer among women from different Spanish regions. After identifying the most important food sources of the relevant nutrients in the study population, the final version of the questionnaire asked about consumption of 118 food items. Its reproducibility and validity were tested among 147 Spanish women aged 18-74 years. These subjects were asked to complete the questionnaire before and after completing four 4-day food records. The records were obtained at 3-month intervals designed to represent daily and seasonal changes (between 1990 and 1991). Using the information available from standard Spanish food composition tables, an ad hoc computer program was created to translate food consumption into nutrient intake. The reproducibility of the questionnaire was assessed by means of estimating correlations between nutrient scores measured with the same instrument twice, with a period of 1 year between estimates. Pearson correlation coefficients ranged from 0.51 for saturated fat to 0.88 for alcohol. In the validity study, correlation coefficients between diet records and the first and second questionnaires ranged between r = 0.20 for vitamin A and r = 0.88 for alcohol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Self-administered food frequency questionnaire: the effect of different designs on food and nutrient intake estimates.

BACKGROUND: Our objective was to determine the possible influence that different designs of a food frequency questionnaire might have on food, energy and nutrient intake estimates. METHODS: A population-based survey included 6783 women, 40-70 years old, living in central Sweden. Using a factorial study design, we compared eight different types of questionnaire covering combinations of three factors: increasing/decreasing frequency categories; addition of portion sizes; and addition of non-dietary questions. All questionnaires included the same list of 60 food items. One of the eight questionnaires was mailed to each subject according to a random assignment. The overall response rate was 77%. RESULTS: Compared with increasing frequencies, decreasing order of frequency categories entailed 3-11% higher estimates of mean intake for 7 of 14 food groups, 4% higher estimates for energy and 3-6% higher estimates for 13 of 18 nutrients. Addition of portion sizes had heterogeneous effects, both on dietary items (e.g. from -30% decrease for eggs to +76% increase for coffee) and on calculated nutrients (from -7% for beta-carotene to +19% for vitamin C). The inclusion of some additional non-dietary questions did not influence the estimated mean intake of any food or nutrient. CONCLUSIONS: The results of this study have implications for the design of questionnaires and for pooled analyses in nutritional epidemiology, when different food questionnaires are used.

Adult↗
PubMed1994

Reproducibility and validity of a self-administered physical activity questionnaire.

BACKGROUND: The reproducibility and validity of self-administered questionnaires on physical activity and inactivity were examined in a random (representative) sample of the Nurses' Health Study II cohort and a random sample of African-American women in that cohort. METHODS: Repeat questionnaires were administered 2 years apart. Past-week activity recalls and 7-day activity diaries were the referent methods; these instruments were sent to participants four times over a 1-year period. RESULTS: The 2-year test-retest correlation for activity was 0.59 for the representative sample (n = 147) and 0.39 for the African-American sample (n = 84). Correlations between activity reported on recalls and that reported on questionnaire were 0.79 and 0.83 for the representative and African-American samples, respectively. Correlations between activity reported in diaries and that reported on questionnaire were 0.62 and 0.59, respectively. Test-retest coefficients for inactivity were 0.52 and 0.55, respectively. Correlations between inactivity reported in diaries and that reported on questionnaire were 0.41 and 0.44, respectively. CONCLUSION: The simple, short questionnaires on activity and inactivity used in the Nurses' Health Study II are reasonably valid measures for epidemiological research.

Adult↗
PubMed2000

Assessing research outcomes by postal questionnaire with telephone follow-up. TOTAL Study Group. Trial of Occupational Therapy and Leisure.

BACKGROUND: Face-to-face assessment of research outcomes is expensive and may introduce bias. Postal questionnaires offer a cheaper alternative which avoids observer bias, but non-response and incomplete response reduce the effective sample size and may be equally serious sources of bias. This study examines the extent and potential effects of missing data in the postal collection of outcomes for a large rehabilitation trial. METHODS: Questionnaires containing a number of established scales were posted to participants in a trial of occupational therapy after stroke. Response was maximized by telephone and postal reminders, and incomplete questionnaires were followed up by telephone. Scale scores obtained by imputing values to questionnaire items missing on return were compared with those achieved by telephone follow-up. FINDINGS: Response to the initial posting was 60%, rising to 85% after reminders. Participants receiving the experimental treatment were more likely to respond without a reminder. There were no significant differences on any known factors between eventual responders and non-responders. Of the questionnaires, 43% were incomplete on return: partial responders were significantly different to complete responders on baseline disability and home circumstances. Of the incomplete questionnaires, 71% were resolved by telephone follow-up. In these, the scale scores achieved by telephone were generally higher than those derived by conventional imputation. CONCLUSION: Postal outcome assessment achieved a good response rate, but considerable effort was needed to minimize non-response and incomplete response, both of which could have been serious sources of bias.

Bias↗
PubMed1995

A brief, telephone-administered food frequency questionnaire can be useful for surveillance of dietary fat intakes.

A 13-item questionnaire designed for quick telephone administration was evaluated for use in surveillance of fat intake in the United States. Study populations included 560 middle-aged and older adults from Beaver Dam, WI, 252 middle-aged and older women from Wisconsin, 73 young, low income Hispanic women from Chicago, IL, 52 older adults from Arizona and 135 younger adults from Augusta, GA. Correlations between fat scores and fat intakes measured by multiple food records or recalls or by more extensive food frequency questionnaires ranged from 0.33 to 0.60, similar to results from other published questionnaire validation studies. Correlations with percentage of energy from fat were lower (0.26 to 0.42), except for the Chicago population, for which there was no correlation (-0.02). There was no systematic variation in correlations among other subgroups defined by demographic and health-related characteristics, including race (black vs. white). Most, but not all, of the substantial differences in fat intakes among subgroups were identified by the questionnaire. The questionnaire will not capture small differences in intakes among groups and is inappropriate when the sample size is limited or for populations with diets substantially different from the typical U.S. diets, such as the Chicago population. However, with attention to its limitations, the questionnaire is useful for surveillance.

Adolescent↗
PubMed2000

Calibration of the dietary questionnaire for a multiethnic cohort in Hawaii and Los Angeles.

The performance of the dietary questionnaire used in a multiethnic cohort study in Hawaii and Los Angeles was assessed in a calibration substudy that compared diet reported from the questionnaire with three 24-hour dietary recalls. For the calibration substudy, subjects from each of eight subgroups defined by sex and ethnic group (African-American, Japanese-American, Latino, and White) were chosen randomly from among the cohort members, and each participant's previous day's diet was assessed by telephone recall on three occasions over approximately 2 months. After completing the three 24-hour recalls, each calibration subject was sent a second questionnaire; 1,606 persons completed three recalls and a second questionnaire (127 to 267 per ethnic-sex group). This report describes correlation coefficients and calibration slopes for the relation between the 24-hour recalls and second questionnaire values for a selected set of macro- and micronutrients, as absolute intakes, nutrient densities, and calorie-adjusted nutrients. In all subgroups, estimates of the correlation between the questionnaire and 24-hour recalls were greater after energy adjustment (average correlations ranged from 0.57-0.74 for nutrient densities and from 0.55-0.74 for calorie-adjusted nutrients) than when absolute nutrient values were used (average range 0.26-0.57). For absolute nutrient intakes, the correlations were greatest for Whites, somewhat lower for Japanese-Americans and Latinos, and lowest for African-Americans. After energy adjustment, the difference between subgroups were diminished, and the correlations were generally highly satisfactory.

Black or African American↗
PubMed1988

The use of a self-administered questionnaire to assess diet four years in the past.

The use of a mailed, self-administered, semiquantitative food frequency questionnaire to describe past dietary intake was evaluated in 1984 among a group of 150 Boston-area women who had completed four one-week diet records three to four years previously. Correlation coefficients comparing calorie-adjusted nutrient intakes computed from the questionnaire with those obtained from a compressed version of the questionnaire completed during diet record keeping ranged from 0.44 for total carbohydrate to 0.62 for vitamin C including supplements. Coefficients comparing calorie-adjusted nutrient intakes measured by questionnaire with those assessed by the diet records completed three to four years previously ranged from 0.28 for iron without supplements to 0.61 for total carbohydrate. An evaluation of the incremental contribution provided by several open-ended sections of the questionnaire to the estimation of nutrient intake suggested that in this population most of these items might be eliminated without material loss of information. These findings demonstrate that useful estimates of nutrient intake several years previously can be obtained by a relatively inexpensive, mailed, self-administered questionnaire.

Adult↗
PubMed1988

Counting calories: partitioning energy intake estimates from a food frequency questionnaire.

Differences in energy estimates between a food frequency questionnaire and a multi-day dietary record can be partitioned into distinct components due to differences in reported frequency of consumption and in reported serving size, and to differences in nutrient composition between the questionnaire standards and the foods reported on the records. The effect of each component on the relative validity of the questionnaire can be assessed by examining its contribution to the differences between the two methods in estimated group intake and in the relative ranking of individual respondents. This methodology was used for the 1984-1985 University of Michigan Food Frequency Study, in which the estimated energy intake from a quantitative food frequency questionnaire was compared with that from 16 days of food records collected over the course of a year from 228 white and black men and women aged 24-51 years. For all race-sex subgroups, mean energy intake estimated from the questionnaire was significantly greater than mean intake estimated from the record. Within race-sex subgroups, the correlations between estimates from the two methods were low, and agreement in classification by tertiles was poor. The differences in group mean energy intake between the methods were due to the effects of discrepancies in both serving size and frequency of consumption. However, the low correlations and poor agreement in classification for individual respondents were due principally to the effect of discrepancies in frequency. These results suggest that improving the accuracy of frequency estimation is a key element in increasing the relative validity of food frequency questionnaires used for epidemiologic research.

Adult↗
PubMed1990

The validity of questionnaire reports of a history of acute otitis media.

A random sample of 2,512 children with an estimated date of birth between July 1, 1985 and June 30, 1986 was monitored to age 2 years, and infection data based on a questionnaire and medical records were compared to evaluate the validity of questionnaire reports of a history of acute otitis media. The cumulative incidence of acute otitis media up to age 2 years in the questionnaire data was lower than in the record data (47.8 vs. 71.0%, respectively), although the number of episodes per child per year, the incidence rate for recurrent episodes, was considerably higher in the questionnaire data (1.27 vs. 0.93). The amount of acute otitis media was distinctly higher among the children of the nonrespondent parents. Finally, a tendency of questionnaire-based data sampling to damp the associations between various risk factors and acute otitis media is displayed. The results identify possible drawbacks which must be considered when interpreting questionnaire-based assessments of acute otitis media in childhood.

Acute Disease↗