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PubMed2006

Cross-cultural adaptation of a tobacco questionnaire for Punjabi, Cantonese, Urdu and Sylheti speakers: qualitative research for better clinical practice, cessation services and research.

OBJECTIVE: To develop cross-culturally valid and comparable questionnaires for use in clinical practice, tobacco cessation services and multiethnic surveys on tobacco use. METHODS: Key questions in Urdu, Cantonese, Punjabi and Sylheti on tobacco use were compiled from the best existing surveys. Additional items were translated by bilingual coworkers. In one-to-one and group consultations, lay members of the Pakistani, Chinese, Indian Sikh and Bangladeshi communities assessed the appropriateness of questions. Questionnaires were developed and field tested. Cross-cultural comparability was judged in a discussion between the researchers and coworkers, and questionnaires were finalised. Questionnaires in Cantonese (written and verbal forms differ) and Sylheti (no script in contemporary use) were written as spoken to avoid spot translations by interviewers. RESULTS: The Chinese did not use bidis, hookahs or smokeless tobacco, so these topics were excluded for them. It was unacceptable for Punjabi Sikhs to use tobacco. For the Urdu speakers and Sylheti speakers there was no outright taboo, particularly for men, but it was not encouraged. Use of paan was common among women and men. Many changes to existing questions were necessary to enhance cultural and linguistic appropriateness-for example, using less formal language, or rephrasing to clarify meaning. Questions were modified to ensure comparability across languages, including English. CONCLUSION: Using theoretically recommended approaches, a tobacco-related questionnaire with face and content validity was constructed for Urdu, Punjabi, Cantonese and Sylheti speakers, paving the way for practitioners to collect more valid data to underpin services, for sounder research and ultimately better tobacco control. The methods and lessons are applicable internationally.

Community Health Services↗
PubMed1988

Repeatability of a questionnaire to assess respiratory symptoms in smokers.

To evaluate the repeatability of a questionnaire designed to assess change in respiratory symptoms 90 smokers were interviewed on two occasions. The questionnaire included questions from the Medical Research Council questionnaire on respiratory symptoms, questions on acute chest illness and cough and phlegm production in the preceding two weeks, a modification of Field's card system for estimating frequency of cough, and an objective assessment of the presence of phlegm--the loose cough sign. The study was carried out in two parts. During the first part 30 male smokers were interviewed by one observer and then re-interviewed 1 to 2 hours later by a different observer. During the second part 60 subjects were interviewed and then after a period of 1 to 10 days re-interviewed by the same observer. The results showed that the within-subject variation representing the measurement error for Field's card system was 15.1% of the between-subject variation and was adequately Normal to justify the use of standard analytical techniques. Similar results were obtained from questions on cough and phlegm scored between 1 and 5, although the variation in this case was rather less Normal. In general, the between-observer, within-observer, and within-subject repeatability were satisfactory for all parts of the questionnaire with the exception of the loose cough sign which had a relatively low prevalence. There was no evidence of an observer order effect and there were no important systematic differences due to lapses in time or different observers.The findings indicate that the techniques such as the cough scoring system may be used to permit studies of respiratory symptoms via questionnaire methods to be much smaller than those required to detect equivalent differences in prevalences.

Adult↗
PubMed1990

Use of questionnaires in a study of spontaneous abortion in a general population.

STUDY OBJECTIVE: The aim was to evaluate the appropriateness of postal questionnaires in studies of spontaneous abortion in a general population. DESIGN: Survey of spontaneous abortions by comparing diagnoses reported in questionnaires to information collected from hospital records and a discharge register. SETTING: The study took place in the general community. PARTICIPANTS: The study involved a random sample of 1400 women born between 1935 and 1960, living in two towns in the south west of Sweden. MEASUREMENTS AND MAIN RESULTS: 9% of spontaneous abortions among respondents were not reported in the questionnaire, and 31% were missing in the register; 80% of the spontaneous abortions reported in the questionnaire could be verified in hospital records, and a further 7% were mentioned in the records but not certified by a doctor; 97% of the diagnoses received by the women who had answered affirmatively to two complementary questions on spontaneous abortions could be found in the records. CONCLUSIONS: Postal questionnaires can be used in epidemiological studies of spontaneous abortions, among a general population as well as among occupational groups.

Abortion, Spontaneous↗
PubMed2002

It doesn't cost anything just to ask, does it? The ethics of questionnaire-based research.

Patient-based outcome measures are increasingly important in health care evaluations, often through the use of paper-based questionnaires. The likely impact of questionnaires upon patients is not often considered and therefore, the balance of benefit and harm not fully explored. Harms that might accrue for research staff are even less frequently considered. This paper describes the use of postal questionnaires within a study of breast disease management in primary care. Questionnaire responses are used to describe the nature of discomfort or harms that may occur in such studies. Ethical issues raised by the harms are discussed in relation to the benefits of the study. Practical suggestions for reducing harm to patients are proposed. A secondary consideration, discomfort to the researcher, is also identified and suggestions made to reduce its effect. Finally, the role of research questionnaires as a study intervention is discussed.

Biomedical Research↗
PubMed2000

Efficacy of a touchscreen computer based family cancer history questionnaire and subsequent cancer risk assessment.

OBJECTIVE: A computer based touchscreen family cancer history questionnaire was developed and implemented to facilitate the provision of cancer risk assessments for the ambulatory and outpatient populations of a free standing cancer hospital. METHODS: A questionnaire consisting of a series of branched point decision making screens was developed which enables the participant to enter demographic data, personal cancer history, and cancer histories for first and second degree relatives. A freestanding touchscreen computer kiosk system was used to place the questionnaire in public areas of the cancer hospital and clinic. Genetic professionals analysed the data received, using published criteria, and provided a basic cancer risk assessment and surveillance recommendations within 10 business days. A survey was completed by a small random group of users (n = 59) three to six months after receipt of their risk assessment. RESULTS: After 11 months, 1440 people had entered information and received a written communication. Only 2% of completed questionnaires contained insufficient information to provide a basic risk assessment. Of the small group of participants surveyed, almost all (95%) felt "very comfortable" using the system, 93% remembered receiving the risk assessment letter when queried three to six months later, 42% felt their perceptions about cancer risk had changed, and 20% had made changes in their or their family's cancer surveillance practices. CONCLUSION: The touchscreen computer family history questionnaire allows easy collection of family history information, provision of risk assessments to a broad population, and promotes increased awareness of familial risk and appropriate surveillance.

Cancer Care Facilities↗
PubMed1996

Reliability of a questionnaire on sickness absence with specific attention to absence due to back pain and respiratory complaints.

OBJECTIVE: To evaluate the performance of a questionnaire on sickness absence due to back pain and respiratory disorders with the view of using sickness absence as a measure of morbidity. METHODS: A cross sectional survey was conducted among 511 male workers aged 20-65, drawn from the personnel register of an animal feed mill. The response was 404 (79%) participants. Data on sickness absence in the six months before the survey were collected by a self administered questionnaire and by sickness absence records. Correlation between both methods was examined for prevalence, duration, and frequency of overall sickness absence, back pain absence, and absence due to respiratory complaints. RESULTS: The questions about the prevalence of sickness absence from all causes, back pain, and respiratory complaints showed a high specificity of 91%, 97%, and 98%, respectively. The sensitivities of these questions were 79%, 88%, and 13%, respectively. The survey found a moderate agreement between the questionnaire and the medical register for duration and frequency of overall sickness absence with kappa values of 0.54 and 0.50. A good agreement was found for back pain absence with kappa values of 0.65 and 0.61. Respiratory absence showed a poor agreement of 0.16 and 0.13. CONCLUSION: In epidemiological studies questionnaires might be considered a valuable source of information on overall sickness absence or absence due to back pain which lasted for at least two weeks in the past six months. Whether a questionnaire survey is a reliable source of data on sickness absence due to respiratory complaints remains to be seen.

Absenteeism↗
PubMed2005

The OutPatient Experiences Questionnaire (OPEQ): data quality, reliability, and validity in patients attending 52 Norwegian hospitals.

OBJECTIVE: To describe the development and evaluation of the OutPatient Experiences Questionnaire (OPEQ) for somatic outpatients. DESIGN: Literature review, patient interviews, pretesting of questionnaire items, and a cross sectional survey. SETTING: Postal survey of adult outpatient clinics at 52 hospitals in all five regions of Norway during 2003 and 2004. SUBJECTS: 35,719 patients who had attended an outpatient clinic within the previous 3 weeks. RESULTS: 19,266 patients (53.9%) responded to the questionnaire. Low levels of missing data suggest that the questionnaire is acceptable to patients. Factor analysis of items applicable to all patients produced three factors: clinic access (two items), communication (six items), and organisation (four items). The remaining items contributed to the hypothesised scales of hospital standards (three items), information (six items), and pre-visit communication (three items). With the exception of the pre-visit communication scale, the levels of Cronbach's alpha were >0.7. With the exception of the hospital standards scale, all produced test-retest correlations that exceeded 0.7. Most of the results of validity testing were as hypothesised. Correlations between the OPEQ scores ranged from 0.30 (clinic access and hospital standards) to 0.73 (communication and information). As hypothesised, scores were significantly related to patient responses to questions about overall satisfaction, general health and age. CONCLUSIONS: The OPEQ is a self-administered questionnaire that includes the most important aspects of patient experience from an outpatient perspective. It has good evidence for internal consistency, test-retest reliability, and validity.

Adolescent↗
PubMed1992

Evaluation of impairment of health related quality of life in asthma: development of a questionnaire for use in clinical trials.

BACKGROUND: In the past only physiological and clinical outcomes have been used to assess the effect of asthma interventions and the effect of the intervention on the lives of the patients has not been determined. The objective of this study was to assess health related impairment of quality of life in adult asthmatic patients and to develop a questionnaire for measuring quality of life in clinical trials in asthma. METHODS: Impairment of quality of life in adults with asthma was evaluated from structured interviews in which patients were asked to identify the parts of their daily lives affected by asthma. On the basis of these results, an asthma quality of life questionnaire was developed in an interviewer and self administered form and tested for comprehension and acceptability. A total of 150 adults with asthma and with a wide range of airway hyperresponsiveness were enrolled from previous clinical trials, local asthma clinics, and notices in the media. RESULTS: Areas of quality of life impairment included symptoms classically associated with asthma, responses to environmental stimuli, the need to avoid these stimuli, limitation of activities, and emotional dysfunction. Areas of impairment were similar across strata of airway hyperresponsiveness, age, and treatment requirements and between sexes, thus allowing a single questionnaire suitable for all adults with asthma to be developed. The questionnaire contains 32 items and takes 5-10 minutes to administer; in the pretesting it was shown to be acceptable to a wide range of patients. CONCLUSIONS: The questionnaire includes areas of quality of life impairment that are important to adult asthmatic patients. It has been designed to be responsive to within subject change and therefore may be used as a measure of outcome in clinical trials in asthma.

Adolescent↗
PubMed1993

Respiratory symptoms questionnaire for asthma epidemiology: validity and reproducibility.

BACKGROUND: There is a need for a new respiratory symptoms questionnaire for use in epidemiological research in asthma. METHOD: A questionnaire was designed following a pilot study in 78 subjects. It contains nine questions on symptoms such as wheeze and difficulty with breathing in defined circumstances such as exercise and sleep. It was completed by 211 adults and validated by comparison with a self reported history of asthma and with bronchial hyperresponsiveness to histamine. Its short term reproducibility was measured by three repeat administrations over two weeks. RESULTS: Subjects with asthma (n = 33), particularly those having had an asthma attack in the last year (n = 23), were more likely to report any symptom and to report a greater number of symptoms than those without asthma. The same relationship was found for bronchial hyperresponsiveness and symptoms. Either two or more, or three or more, symptoms appeared to be good indices of self reported asthma and bronchial hyperresponsiveness, or both, with a high sensitivity (65-91%) and specificity (85-96%). Reproducibility was good, with few subjects changing the number of symptoms reported by more than one symptom and none by more than four symptoms. The results compared favourably with those from questions on phlegm production from the MRC questionnaire and were better than those reported for the MRC wheeze questions. CONCLUSIONS: The questionnaire will be useful for epidemiological research on asthma and could form part of a new standardised questionnaire with wide applications.

Adult↗
PubMed1993

Evaluation of a standardised questionnaire for the detection of dysphagia in 69 dogs.

The diagnosis of dysphagia in the dog requires an evaluation of a variety of signs that can be caused not only by a 'swallowing disorder' but also by several other pathological conditions. Most owners mention coughing, vomiting, regurgitation and nasal discharge, and the clinician must decide whether these signs are related to dysphagia. In this study a standardised questionnaire for the diagnosis and localisation of dysphagia was evaluated for its accuracy by comparing the results with contrast videofluorography as the definitive standard. The purpose of the study was to optimise the selection of dogs for more expensive diagnostic procedures such as videofluorography and electromyography. In a group of 69 dogs with 'swallowing problems' the questionnaire had a sensitivity of 0.97 and a positive predictive value of 0.94 for dysphagia in general. The questionnaire was also useful for the exclusion of oral phase dysphagia, with a specificity of 0.70 and a negative predictive value of 0.97. Most dogs with pharyngeal phase dysphagia could be detected by using the questionnaire (sensitivity 0.91). The questionnaire was not of specific value for the detection or exclusion of oesophageal phase dysphagia, for which it had a sensitivity of 0.69, a specificity of 0.57 and predictive values for positive and negative tests of 0.79 and 0.44, respectively.

Animals↗
PubMed2003

Validation of the GSFQ, a self-administered symptom frequency questionnaire for patients with gastroesophageal reflux disease.

BACKGROUND: Although the diagnosis of gastroesophageal reflux disease (GERD) is based primarily on symptoms experienced by a patient, relatively little attention has been paid to the development and validation of self-administered questionnaires specific to GERD symptoms. The present article presents the validation of the short, self-administered GERD Symptom Frequency Questionnaire (GSFQ). METHODS: Patients with GERD participating in a randomized clinical trial comparing pantoprazole and nizatidine were asked to complete the GSFQ together with validated instruments for measurement of health-related quality of life (Medical Outcome Study Short Form 12) and gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale). Completion of the GSFQ, Medical Outcome Study Short Form 12 and Gastrointestinal Symptom Rating Scale took place upon entry into the trial (baseline) and during the trial (days 7 and 28). Endoscopy was performed at baseline and after 28 days. Cronbach alpha was used to assess the internal consistency of the questionnaire. The test-retest reliability of the GSFQ was examined by the intraclass correlation coefficient among the 36 patients with stable GERD symptoms between day 7 and day 28. Construct validity was assessed by comparing the GSFQ with previously validated instruments. Known group validity was determined by comparing GSFQ scores across groups of patients known to differ clinically. Responsiveness to change was assessed by the Guyatt's statistic. RESULTS: Two hundred twenty-one patients formed the study baseline group. The analysis demonstrated that the GSFQ questionnaire had excellent psychometric properties shown by the high internal consistency (Cronbach alpha 0.84); that the test-retest reliability was satisfactory (intraclass correlation coefficient 0.64); that there was good evidence that the GSFQ indeed measured what it was intended to measure (validity); and that the GSFQ was highly responsive to change (Guyatt's statistic 1.48). DISCUSSION: The GSFQ is a short, self-administered, easy to use, GERD-specific questionnaire which should be considered as a useful assessment tool in the evaluation of patients with GERD and in the assessment of treatment outcomes.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2004

French-Canadian version of the Chronic Respiratory and St George's Respiratory questionnaires: an assessment of their psychometric properties in patients with chronic obstructive pulmonary disease.

BACKGROUND: French versions of the Chronic Respiratory Questionnaire (CRQ) and the St George's Respiratory Questionnaire (SGRQ) have largely been used in Canada, although the process by which they were translated remains unknown and the psychometric properties of these translated versions have not been assessed in a properly designed study. OBJECTIVE: To translate and evaluate the psychometric properties of the French-Canadian versions of the CRQ and the SGRQ. METHODS: The questionnaires were translated according to standardized guidelines for cross-cultural adaptation. Measurements were made at baseline and again after two weeks in 27 chronic obstructive pulmonary disease (COPD) patients known to have stable disease. Measurements were also taken pre- and post-treatment in patients with acute exacerbation of COPD (33 patients) or in pulmonary rehabilitation (32 patients). RESULTS: The CRQ showed high test-retest reliability (the majority above 0.70), although it was slightly lower for the dyspnea dimension (0.58 to 0.65). The SGRQ also showed high test-retest reliability (above 0.80), although it was lower for the symptoms dimension (0.54 to 0.58). The internal consistency reliability coefficients ranged from 0.73 to 0.90 for the CRQ and above 0.80 for the SGRQ, except for the symptoms dimension. The Pearson's correlation coefficients were low (less than 0.30) between most of the translated questionnaire dimension scores and forced expiratory volume in 1 s, 6 min walking test and dyspnea measures. The correlation was generally high (greater than 0.50) between the two questionnaires and the 36-item short form health survey, and for those domains that measured the same construct. The changes in the total and subscale scores of the CRQ and the SGRQ (except for the symptoms domain) were all largely above the variability of the score in the stable disease group. CONCLUSION: The present study confirms that the French-Canadian translated versions of the CRQ and the SGRQ perform well with respect to their psychometric properties. They are both suitable for their intended purpose, ie, to detect change in health status in patients with COPD when assessing if a treatment is beneficial. However, the symptoms domain of the SGRQ cannot be used to assess acute change with respect to a given therapy.

Aged↗
PubMedDate not supplied

Validity and reliability of a French version of the MRF-28 health-related quality of life questionnaire.

BACKGROUND: Evaluation of health-related quality of life (HRQL) in chronic respiratory failure (CRF) is an important issue for evaluating the impact of treatment. OBJECTIVES: To elaborate a French version of the Maugeri Foundation Respiratory Failure Questionnaire (MRF-28) disease-specific HRQL questionnaire and determine its validity and reliability in patients with CRF treated by home mechanical ventilation (HMV). METHODS: Forward- and back-translation of the MRF-28 questionnaire; the final version was submitted to 81 patients treated with HMV for CRF, simultaneously with the St. George's Respiratory Questionnaire (SGRQ), the Short Form 36 (SF-36), and the Hospital Anxiety and Depression scale (HAD). Validity was determined by correlation with previously validated HRQL scores and recorded physiological parameters. Reliability was evaluated by assessing internal consistency and test-retest stability of the MRF-28 scores. RESULTS: The French version of the MRF-28 and its subscores ('daily activity', 'cognitive function', and 'invalidity') were highly significantly correlated with subscores of the SGRQ, the SF-36 and the HAD. Both the MRF-28 and the SGRQ were correlated only with age and the 6-min walk test. The MRF-28 showed high test-retest reliability after 2 weeks (r2 = 0.80, p < 0.0001) and high internal consistency (Crohnbachs' alpha coefficient: 0.91). CONCLUSION: The French version of the MRF-28 is a valid and reliable disease-specific questionnaire for assessing HRQL in patients with CRF.

Adult↗
PubMed2005

Influence of diet on exposure to acrylamide--reflections on the validity of a questionnaire.

AIM: This pilot study attempts to assess how far the standardized questionnaires are a valid tool to detect the food-related burden of acrylamide. Acrylamide is a toxic substance classified by the International Agency of Research on Cancer, as well as the Deutsche Forschungsgemeinschaft, as a probable human carcinogen. METHODS: A venous blood sample was taken in order to determine the smoking-specific acrylnitrile adduct N-cyanoethylvaline and the acrylamide adduct N-2-carbamoylethylvaline in a female study population expecting delivery soon. A standardized questionnaire was used to determine the consumption of acrylamide-contaminated food. The results of our questionnaire were transferred to a linear evaluation system. Finally, anamnestic data of the questionnaire were correlated to objective parameters such as blood levels of hemoglobin adducts of acrylamide and acrylonitrile. RESULTS: A positive correlation between the acrylamide intake and the levels of hemoglobin adducts in our study population was not proven. CONCLUSIONS: Evaluation of food-related exposure to acrylamide is difficult due to several reasons. Firstly, the validity of anamnestic data strongly depends on the patient's ability to remember precisely all consumed food (quality as well as quantity) over a 3-month period. In addition, the contamination of acrylamide in food varies from one product to another; even the contamination of the same product is variable. Therefore, the missing correlation between the questionnaire and hemoglobin adduct rates is rather due to restricted validity of anamnestic data.

Acrylamide↗
PubMed1999

A novel, short, and simple questionnaire to measure health-related quality of life in patients with chronic obstructive pulmonary disease.

A novel, short, and simple questionnaire, the Airways Questionnaire 20 (AQ20), has been developed to measure and quantify disturbances in the health-related quality of life (HRQoL) of patients with asthma or chronic obstructive pulmonary disease (COPD). The AQ20 has 20 items with yes/no responses, and should take 2 min to complete and score. The purpose of this study was to assess the discriminative properties and responsiveness of the AQ20 in patients with COPD. First, in a cross- sectional study, 165 patients with mild-to-severe COPD (mean age, 69 +/- 7 yr; FEV1, 40 +/- 16% of predicted) completed the AQ20, the St. George's Respiratory Questionnaire (SGRQ), the Chronic Respiratory Disease Questionnaire (CRQ), pulmonary function tests, a progressive cycle ergometer exercise test, and an assessment of their dyspnea and anxiety. The score distribution of the AQ20 was skewed toward the mild end of the scale, whereas the SGRQ and CRQ showed a normal distribution. The AQ20 showed a moderately strong correlation with the maximal oxygen uptake and the assessment of dyspnea (Spearman's correlation coefficients [rs] = -0.49, -0.60, respectively), but a weak correlation with the FEV1 (rs = -0.18). Moderate to strong correlations were also recognized between the AQ20 and SGRQ and CRQ (rs = -0.80, -0.72, respectively). Multiple regression analysis revealed that dyspnea and anxiety accounted for 43% of the variance in the AQ20, almost the same as in the SGRQ and CRQ. Second, longitudinal changes over time in the FEV1, AQ20, SGRQ, and CRQ were examined in 86 patients with newly detected COPD (mean age, 69 +/- 8 yr; FEV1, 45 +/- 19% of predicted). All three measures showed significant improvements in their scores over a 3-mo period after initiating medical intervention. The change in the AQ20 showed a moderate to strong correlation with each dimension of the SGRQ and CRQ (rs = 0.56, -0.52, respectively), but no significant correlation was noted with the FEV1. In conclusion, the AQ20 may have discriminative properties and responsiveness that are similar to more complex questionnaires such as the SGRQ and CRQ. Because it is short and can be quickly answered and scored, the AQ20 may be useful in studies with limited time for HRQoL assessments.

Aged↗
PubMed2000

Development and validation of a screening instrument for bipolar spectrum disorder: the Mood Disorder Questionnaire.

OBJECTIVE: Bipolar spectrum disorders, which include bipolar I, bipolar II, and bipolar disorder not otherwise specified, frequently go unrecognized, undiagnosed, and untreated. This report describes the validation of a new brief self-report screening instrument for bipolar spectrum disorders called the Mood Disorder Questionnaire. METHOD: A total of 198 patients attending five outpatient clinics that primarily treat patients with mood disorders completed the Mood Disorder Questionnaire. A research professional, blind to the Mood Disorder Questionnaire results, conducted a telephone research diagnostic interview by means of the bipolar module of the Structured Clinical Interview for DSM-IV. RESULTS: A Mood Disorder Questionnaire screening score of 7 or more items yielded good sensitivity (0.73) and very good specificity (0.90). CONCLUSIONS: The Mood Disorder Questionnaire is a useful screening instrument for bipolar spectrum disorder in a psychiatric outpatient population.

Adolescent↗
PubMed2001

Responses to the Seasonal Pattern Assessment Questionnaire in different seasons.

OBJECTIVE: The study investigated whether results on the Seasonal Pattern Assessment Questionnaire, which is used for diagnosis of seasonal affective disorder, differed by the season in which the questionnaire was completed. METHOD: Every third month from March 1997 to February 1998, a population-based panel of 200 men and women age 27-72 years in Gamvik, northern Norway, completed a standardized questionnaire that included all items from the Seasonal Pattern Assessment Questionnaire. RESULTS: The average score for seasonal affective disorder changed over the year. The difference between the highest score, in March, and the lowest, in September, was 8.8%. CONCLUSIONS: Results on the Seasonal Pattern Assessment Questionnaire varied by season, but did not vary by seasonal differences in the amount of daylight.

Adult↗
PubMed1993

Reliability and validity of an infant gastroesophageal reflux questionnaire.

To improve history-taking of infants with suspected gastroesophageal reflux, we developed an Infant Gastroesophageal Reflux Questionnaire consisting of 161 items covering demographics, symptoms (regurgitation, weight deficit, respiratory difficulties, fussiness, apnea, and pain or bleeding of esophagitis), and possible causes (feeding volume and frequency, allergy, infection, colic, central nervous system abnormalities, positioning, and smoke exposure). The questionnaire was completed by primary caretakers of 69 infants aged 1 to 58 weeks suspected of having reflux. Median time to complete the questionnaire was 20 minutes. The median internal consistency of 29 pairs of redundant questions was 0.94. Median test-retest consistency of 110 items for nine respondents was 0.88. Median interobserver consistency, evaluated for 129 items in 35 questionnaires also filled out by secondary caretakers, was 0.85. The median accuracy of four externally validated items was 1.00. This questionnaire can aid pediatricians in making decisions regarding diagnoses and treatment in this common but complex disorder.

Airway Obstruction↗