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PubMed1998

Reliability and validity of three physical activity questionnaires in Flemish males.

The reliability and validity of three physical activity questionnaires were studied using 90 Flemish males (30 aged 30 years, 30 aged 35 years, and 30 aged 40 years). Intraclass correlations (R) and kappa values were calculated to verify within judge and between judges reliability (objectivity) and test-retest reliability (stability) of the Tecumseh Community Health Study Questionnaire, the Five City Project Questionnaire, and the Baecke Questionnaire. Results showed high for within judge and between judges reliability. R coefficients for stability varied between 0.47 and 0.95. Kappa values varied between 0.20 and 0.73. Concurrent validity was investigated by comparing three levels of professional status. Workmen had higher indices concerning physical activity during work than clerks and managers. Congruent validity, studied by means of principal-components analysis, confirmed subdivision of habitual physical activity into three entities, physical activity during work, sports activities, and general leisure time. These results indicate that reliable and valid data can be obtained in Flemish males by three interviewer-assisted physical activity questionnaires.

Adult↗
PubMed1998

Completeness of ascertainment of prenatal smoking using birth certificates and confidential questionnaires: variations by maternal attributes and infant birth weight. PRAMS Working Group. Pregnancy Risk Assessment Monitoring System.

Birth certificate data frequently are used to monitor the prevalence of smoking during pregnancy. The authors used a two-sample capture-recapture method to estimate the completeness of ascertainment of prenatal smoking on birth certificates and on confidential questionnaires in six US states. Completeness of ascertainment was also examined according to maternal attributes and infant birth weight. The samples included white women who delivered a live infant between 1993 and 1995 in one of six states (Alabama, Alaska, Georgia, Maine, South Carolina, or West Virginia) and who responded to a questionnaire mailed to them 2-6 months postpartum as part of the Pregnancy Risk Assessment Monitoring System. State-specific sample sizes ranged from 2,647 to 4,795. The completeness of ascertainment ranged from 70.6% to 82.0% using birth certificates and from 86.2% to 90.3% using confidential questionnaires. In all six states, the birth certificates' completeness of ascertainment varied by maternal education and infant birth weight, and the questionnaires' completeness varied by maternal age. Both birth certificates and questionnaires underestimated the true extent of smoking during pregnancy among these white women. Differential reporting by birth weights recorded on birth certificates would result in an overestimated association between low birth weight and prenatal smoking.

Adolescent↗
PubMed1985

Assessment of angina pectoris after myocardial infarction: comparison of "Rose Questionnaire" with physician judgment in the Beta-Blocker Heart Attack Trial.

The London School of Hygiene Cardiovascular Questionnaire (Rose Questionnaire) was compared with physician opinion in assessment of angina pectoris in the Beta-Blocker Heart Attack Trial, a long-term (June 1978-October 1981), multicenter study of 3,837 post-myocardial infarction patients, half of whom were treated with propranolol and half with placebo. At baseline, about three times as many patients were thought to have angina by the physician as were diagnosed by the Questionnaire (36.1% vs. 11.5%). Over the average 25-month follow-up period, angina was identified by the physician 50% more often than by the Questionnaire (60.3% vs. 38.6%). The results for each treatment group (propranolol or placebo) were very similar to these overall results. Associations between diagnosis of angina and other patient characteristics were similar for the two measures at baseline. Although the physician diagnosis of angina identified more patients who suffered a subsequent fatal or nonfatal event than did the Questionnaire, it also diagnosed more angina patients who did not have an event. Thus, each of the measures of angina predicted total mortality and coronary heart disease mortality to similar extents (comparable relative risks), even after adjustment for covariates. Neither measure was significantly predictive of recurrent nonfatal myocardial infarction. One measure is not clearly superior to the other in this population. Other factors, such as cost and type of personnel available to conduct the study, may determine which measure is preferred.

Angina Pectoris↗
PubMed1989

Validation of a retrospective questionnaire assessing diet 10-15 years ago.

In 1985, 216 men, participants in the Baltimore Longitudinal Study of Aging, were asked to report on their usual diet during the period 1971-1975. The reference data for past diet consisted of multiple seven-day records collected between 1971 and 1975. The group was randomly assigned to complete the diet history either by personal interview or by mailed self-administered questionnaire. The items and response categories were identical in both cases. For both groups, the mean nutrient intake estimated by questionnaire was within +/- 10 per cent of the past diet record values for most nutrients. When the questionnaire was administered by an interviewer, correlations with past diet were approximately as good as those obtainable with present diet in other studies and indicate that useful studies of past diet can be performed with this questionnaire. Correlations for the mail group were considerably lower and suggest that assessment of past diet using this questionnaire format without personal instruction or callbacks may yield poor results. The effect of age was negligible, but response errors and change in diet since the target period had important effects on correlations with past diet in both interview and mail groups.

Aged↗
PubMed1990

Assessment of the validity of a food frequency questionnaire as a measure of food use by comparison with direct observation of domestic food stores.

The aim of this study was to assess the validity as a measure of food use of a 90-item semi-quantitative food frequency questionnaire which had been used in a study of food consumption patterns and health among 3,000 people aged 65 years and over selected at random from the electoral rolls of Adelaide, South Australia. In 1986, 18 months after the original survey, 200 randomly selected participants were invited to take part in the present study. The food frequency questionnaire was administered by mail, and results were compared with a direct observation of the foods that 40 subjects had in their home. The kappa statistic indicated good agreement (in all cases greater than that expected due to chance) between the reported use of individual foods in the questionnaire and the observed presence or absence of those foods in the subject's home. Correlation coefficients between scores generated from the questionnaire for consumption from specific food groups and those derived from direct observation of domestic food stores ranged from 0.42 to 0.86. These data indicate that a simple self-administered dietary questionnaire can provide a valid measure of food use patterns in elderly people.

Aged↗
PubMed1990

Possible factors affecting response to postal questionnaires: findings from a study of general practitioner services.

Poor response rates affect the validity of results from postal questionnaires. The effect of three controllable factors upon response rates was examined in a recent study of patients' experiences and views of general practitioner services. The factors studied were the institution from which questionnaires were dispatched, the length of the questionnaire and the inclusion of a potentially sensitive question about ethnic origin. Questionnaires sent out by local Family Practitioner Committees were more likely to be returned than those sent out by a London-based independent research unit, but there were no differences in the nature of replies obtained. Neither the length of the questionnaire nor the inclusion of the potentially sensitive question affected response rates. The results of the study indicate that Family Practitioner Committees wishing to carry out postal surveys of users of general practitioner services can obtain satisfactory response rates.

Consumer Behavior↗
PubMed1985

Developing effective questionnaires.

Many research questions are effectively answered by collecting data about the opinions, beliefs, and perceptions of large numbers of persons in widely dispersed areas. The questionnaire is an economical means of gathering such information. Properly designed questionnaires can collect valid and reliable data for analyzing a research problem. This article reviews fundamental principles of questionnaire design and presents a matrix to guide the construction of a questionnaire. Methods to avoid common problems and pitfalls in developing a questionnaire are also presented. Field testing is recommended to ensure validity and reliability.

Data Collection↗
PubMed1994

Functional assessment in ankylosing spondylitis: evaluation of a new self-administered questionnaire and correlation with anthropometric variables.

We describe the development of a new self-administered questionnaire for assessment of specific disability in ankylosing spondylitis (AS). The questionnaire was derived both from discussion with patients and from previous published material and covered four main areas of function: mobility, bending down, reaching up and neck movements, and posture. Four categories of response were available similar to the Stanford Health Assessment Questionnaire and the questionnaire was similarly scored providing a range of scores from 0-3. The questionnaire was found to be acceptable, understandable, easy to complete and fulfilled recognized criteria for reproducibility and validity. A significant improvement in functional score as a result of treatment was found in a longitudinal study of physiotherapy in 42 subjects with AS (pre-treatment score 1.23 +/- 0.79, post-treatment 1.07 +/- 0.75 P < 0.01). The areas which showed the most improvement were mobility, bending and posture. Functional scores correlated well with some anthropometric variables, particularly cervical movements, finger to floor distance and chest expansion. Both spinal and peripheral joint impairment contributed to functional disability.

Anthropometry↗
PubMed1998

The assessment of knowledge in ankylosing spondylitis patients by a self-administered questionnaire.

The aim of the present study was to assess ankylosing spondylitis (AS) patients' level of knowledge, using a self-administered multiple-choice questionnaire. The questionnaire, based on the Arthritis and Rheumatism Council (ARC) leaflet on AS, examined four areas: (A) general knowledge; (B) immunogenetic tests and inheritance; (C) general management; (D) joint protection, pacing and priorities. Statistical analysis was used to validate the questionnaire and to examine correlations with gender, age, disease duration and level of general education. The questionnaire was consistent, reliable and easy to read. The results showed AS patients to have a high level of knowledge (mean = 19.4, maximum possible = 25), although some wrong beliefs about the role of blood tests, the HLA-B27 antigen and inheritance were discovered. No statistical correlation was found between gender, age, duration of the disease, level of general education and the level of knowledge. These data suggest that this questionnaire is a simple way to detect the level of knowledge of patients with AS. The average score achieved by AS patients was outstanding, possibly reflecting the good quality of previous educational programmes. Patients' confusion regarding blood tests, genetics and inheritance was highlighted and should be addressed.

Activities of Daily Living↗
PubMed2005

Validity and reliability of an Italian version of the revised Leeds disability questionnaire for patients with ankylosing spondylitis.

OBJECTIVE: The purpose of the present study was to produce an Italian version of the Revised Leeds Disability Questionnaire (LDQ) in a group of patients with ankylosing spondylitis, and to examine the psychometric properties of this version, evaluating its internal consistency, external validity and reliability. METHODS: The LDQ was administered to 60 Caucasian patients affected by ankylosing spondylitis (50 males, 10 females, mean age 46.1 +/- 14.2 yr, range 22-74, median disease duration 4.5 yr, range 1-24) together with the Italian version of the Stanford Health Assessment Questionnaire (HAQ), and anthropometric measurements. Thirty patients completed the questionnaire after a 10-day interval. Internal consistency was evaluated with Cronbach's alpha coefficient of reliability. Construct validity of the LDQ was evaluated using the correlation between the HAQ and anthropometric measurements. Test-retest reliability was assessed with the intraclass correlation coefficient. RESULTS: All patients completed the validation study. The questionnaire was internally consistent (alpha=0.90). A significant correlation was recorded between the LDQ and the HAQ score (rho=0.841, P<0.01) and the anthropometric measurements. Test-retest reliability showed a good correlation coefficient (intraclass correlation=0.97). CONCLUSION: The Italian LDQ is a valid and reliable instrument for detecting and measuring functional disability in patients with ankylosing spondylitis. Our results confirm the utility of this questionnaire as a valid and feasible functional measure for patients with ankylosing spondylitis.

Adult↗
PubMed1997

Mind your manners. Part III: Individual scenario results and discussion of the National Association of Medical Examiners Manner of Death Questionnaire, 1995.

In 1995, a questionnaire was distributed to the > 700 physician medical examiner/coroners (ME/Cs) who are members of the National Association of Medical Examiners (NAME, St. Louis, MO, U.S.A.). The questionnaire consisted of 23 death scenarios for which individual responders were asked to assign a manner of death (homicide, suicide, accident, natural, or undetermined); 198 questionnaires were completed and analyzed. The distribution of manner of death responses was tabulated. In addition, a nosologist from the National Center for Health Statistics was provided with a cause-of-death statement based on each scenario and was asked to assign an International Classification of Diseases (ICD) code for the underlying cause of death, from which a manner of death was inferred from the ICD code's literal text description. Overall, agreement on a given manner of death in a single scenario was > 90% in only 4 of 23 scenarios and > 70% in only 12 of 23 scenarios. However, in 21 scenarios, the most common response comprised a majority. The manner of death inferred from the ICD code that was assigned by the National Center for Health Statistics (NCHS) matched the most common response of participants in 18 of the 23 scenarios. The questionnaire results show that there is substantial disagreement among experienced MEs concerning the manner of death classification that is preferred for selected types of death. Encouraging, however, is the fact that the manner of death coded for statistical purposes generally agreed with the most common classification of manner made by ME/Cs. Highlights from the discussion of each scenario that occurred during the NAME interim meeting (Nashville, Tennessee, February 1996) are also included. Other portions of the program including history of manner of death concepts and results of questions regarding responder training and characteristics are published separately in this issue of the Journal. Information derived from the questionnaire should be useful to those planning strategies to improve the consistency of manner of death classifications by ME/Cs.

Autopsy↗
PubMed1990

A reduced dietary questionnaire: development and validation.

A reduced questionnaire was developed by successively omitting segments of the full (98-item) Block questionnaire and calculating the correlations between nutrient estimates produced by the full and reduced versions. The reduced version contains 60 food items and requires 17 minutes to administer by an interviewer. It is intended to capture all nutrients in the diet, as is the full version. The reduced version was validated against three four-day records in a group of middle-aged women, and against two seven-day records collected 10-15 years ago in a group of older men. The absolute value of macronutrients estimated by the reduced questionnaire was lower than food-record estimates, but most micronutrients were not underestimated. For macronutrients correlations with food records were slightly lower with the reduced questionnaire, but for micronutrients there was only slight or no reduction in correlations as a result of using the reduced version. The brief version may be useful in studies that cannot allow the 30-35 minutes required for the full-length questionnaire.

Aged↗
PubMed1993

Evaluation of a brief telephone questionnaire to estimate fruit and vegetable consumption in diverse study populations.

We evaluated the use of a six-item telephone questionnaire to estimate fruit and vegetable intakes in five diverse populations. Researchers administered the telephone questionnaire to persons who had previously undergone more extensive dietary assessment. The study population included 553 middle-aged and older adults in Beaver Dam, WI; 252 middle-aged and older women throughout Wisconsin; 150 parents of school children in Augusta, GA; 73 low-income, Hispanic mothers in Chicago, IL; and 51 older adults in Arizona. Spearman correlation coefficients between total fruit and vegetable intakes measured by the brief telephone survey and by more extensive food frequency questionnaires were 0.47 (Augusta), 0.48 (Arizona), 0.56 (Wisconsin), and 0.57 (Beaver Dam). Correlations between intakes measured by the brief telephone survey and by multiple diet records or recalls were 0.29 (Arizona), 0.46 (Chicago), and 0.54 (Beaver Dam). With the exception of Arizona, mean daily fruit and vegetable intakes measured by the telephone survey were similar to intakes estimated by multiple diet records or recalls and lower than those estimated by extensive food frequency questionnaires. Although caution may be needed in interpreting dietary reports from some ethnic subgroups, this brief telephone questionnaire may be useful for surveillance of fruit and vegetable intake in the United States.

Adolescent↗
PubMed2000

Validation of the American Cancer Society Cancer Prevention Study II Nutrition Survey Cohort Food Frequency Questionnaire.

We assessed the validity and reproducibility of a self-administered 68-item food frequency questionnaire completed in 1992-1993 by approximately 185,000 adults. Four hundred forty-one participants completed four 24-hour dietary recall interviews over a 1-year period and a repeat administration of the food frequency questionnaire. For 20 nutrients and 10 food groups, measured nutrient intakes, but not food group intakes, were consistently lower by food frequency questionnaire than by recall. Energy-adjusted, attenuation-corrected Pearson validity correlations ranged from 0.12 to 0.80, with a median of 0.58. Reproducibility measures were generally high, with a median of 0.69. The food frequency questionnaire performed similarly to food frequency questionnaires used in other cohort studies, indicating similar ability to examine diet-disease relations.

Adult↗
PubMed2002

The performance of the contact lens dry eye questionnaire as a screening survey for contact lens-related dry eye.

PURPOSE: The contact lens dry eye questionnaire (CLDEQ) is a self-administered survey developed to examine the distribution of dry eye symptoms among contact lens wearers. In this report, we examine the CLDEQ as a screening survey for contact lens-related dry eye and compare it with McMonnies' questionnaire. METHODS: The CLDEQ and McMonnies' questionnaire were administered to 367 unselected contact lens wearers at six clinics across the United States and Canada. After completion of the surveys, doctors unaware of the survey results completed a separate form indicating contact lens-related dry eye diagnosis at the end of a nondirected clinical examination. The CLDEQ is composed of nine habitual symptom subscales and a self-diagnosis question, which were tested for their predictive value for a diagnosis of contact lens-related dry eye. McMonnies' instrument was scored with use of the algorithm suggested in the literature. Sensitivity, specificity, and receiver operator characteristic (ROC) curve analyses were performed for each instrument on the basis of logistic regression results. RESULTS: The area under the ROC curve for the CLDEQ was 0.74, indicating moderate contact lens-related dry eye discrimination, and the Hosmer-Lemeshow goodness-of-fit test indicated that the CLDEQ was well calibrated (p = 0.84). The area under the ROC curve for McMonnies' questionnaire was 0.56, indicating poorer discrimination, and the Hosmer-Lemeshow goodness-of-fit test indicated it was also poorly calibrated (p = 0.08) for contact lens wearers. CONCLUSIONS: These analyses suggest that the CLDEQ is capable of discriminating contact lens-related dry eye and is accurate in doing so, especially in comparison with McMonnies' questionnaire. The CLDEQ is an efficient screening survey and may be used in future clinical research and epidemiologic studies of contact lens-related dry eye.

Adolescent↗
PubMed1990

The psychometric properties of a tinnitus handicap questionnaire.

The psychometric properties of a tinnitus handicap questionnaire are reported. There were two phases in this study. In Phase I, 87 questions were administered to 100 tinnitus patients. From their responses, 59 items that were either redundant, insensitive, or had low item-total correlations were eliminated. In Phase II, the resulting 27-item questionnaire was administered to 319 patients. Fifty-three of these patients also completed psychological and psychophysical measures that were used to validate the questionnaire. A factor analysis of patients' responses revealed a three-factor structure. These three factors appeared to reflect the physical, emotional, and social consequences of tinnitus (Factor 1), hearing ability of the patient (Factor 2), and the patients' view of tinnitus (Factor 3). Although the 27-item questionnaire had high internal consistency reliability and validity as reflected by correlations with life satisfaction and depression scales, it is recommended that only the items on the Factor 1 and the Factor 2 subscales be scored because of the low internal consistency reliability of the Factor 3 subscale. This questionnaire can be used to compare a patient's tinnitus handicap with the norm, identify specific areas of handicaps, and to monitor a patient's progress with particular treatment programs.

Female↗
PubMed1993

A patient knowledge questionnaire in inflammatory bowel disease.

A multiple choice knowledge questionnaire was developed for patients with inflammatory bowel disease (IBD). Initially, 20 questionnaires were piloted, and then questions of poor discriminatory ability (> 75% patients giving a correct response) were eliminated. A second pilot study proved the internal consistency (coefficient alpha = 0.84) and the stability of the questionnaire using a test-retest method (Spearman R = 0.86, p = 0.002). The questionnaire was then completed by 60 randomly selected patients attending colitis clinic. The mean score was 13 of a total of 36 (range 2-29). Eighty percent of patients wished to know more about their disease. Knowledge score was higher in patients who were members of the National Association of Crohn's Disease and Colitis (NACC) (p < 0.005) and in patients with Crohn's disease (CD) rather than ulcerative colitis (UC) (p < 0.005). Knowledge score correlated with the number of years spent in full-time education (R = 0.48, p < 0.001) and inversely with age (R = -0.33, p < 0.02) but did not correlate with disease duration. The study demonstrated some misunderstandings about IBD although most patients would have liked more information. The questionnaire could be used as a tool to evaluate patient education programs.

Colitis, Ulcerative↗
PubMed1995

Angina pectoris by Rose questionnaire does not predict cardiovascular disease in treated hypertensive patients.

OBJECTIVE: To determine the predictive value of angina pectoris diagnosed by Rose questionnaire for cardiovascular disease among treated hypertensives. METHODS: The cardiovascular experience of 4093 patients who had no history of cardiovascular disease and had been administered the Rose questionnaire for angina in a worksite treatment program was evaluated. RESULTS: Among 2659 men and 1434 women of similar age (53 versus 54 years), the race distribution was 44 versus 31% whites, 27 versus 41% blacks and 29 versus 28% Hispanics. Overall, the prevalence of angina by Rose questionnaire in women (15%) was twice that in men (7%) in all three races, with Hispanics having the highest (20 versus 10%) prevalence. Those with angina (Rose-plus) and those without (Rose-minus) had similar initial and final blood pressures. In 4.0 years of average follow-up study, the crude incidence rates (per 1000 person-years) of the recorded 120 myocardial infarctions and 35 strokes did not differ significantly between Rose-plus and Rose-minus patients, except for myocardial infarction in Hispanic men (20.5 versus 5.9). When myocardial infarction incidence was adjusted for age within each sex-race subgroup, only Rose-plus Hispanic men had a significantly greater relative risk with Rose-minus as referent (relative risk 3.13, 95% confidence interval 1.31-7.50). Overall, in the Cox proportional hazards regression model, angina by Rose questionnaire was not predictive of myocardial infarction after accounting for other recognized risk factors. CONCLUSIONS: The present data suggest that the Rose questionnaire as a diagnostic tool for angina is not predictive of subsequent clinical events among treated hypertensive patients.

Adult↗