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Screening for alcohol abuse using the CAGE questionnaire.

A prospective study of 518 patients admitted to the orthopedic and medical services of a community-based teaching hospital during a six-month period was performed to test the hypothesis that a short, easily administered questionnaire would improve the detection rate by physicians of alcohol abuse. The CAGE questionnaire--a mnemonic for attempts to cut back on drinking, being annoyed at criticisms about drinking, feeling guilty about drinking, and using alcohol as an eye opener--was utilized as a screening instrument. The mean corpuscular volume of red blood cells, liver transaminase levels, and the gamma-glutamyl transpeptidase level were also evaluated as screening tests. The presence or absence of alcoholism and alcohol abuse for a consecutive sample of CAGE-negative patients and all patients answering "yes" to one or more of the CAGE questions was established through the administration of the Michigan Alcoholism Screening Test, a detailed chart review, and analysis of quantity of alcohol consumed. Diagnostic criteria were those described in the Diagnostic and Statistical Manual III. The prevalence of alcohol abuse was 20 percent. The mean corpuscular volume, gamma-glutamyl transpeptidase value, and liver transaminase levels were very insensitive as screening tests. In contrast, the CAGE questionnaire had a sensitivity of 85 percent and a specificity of 89 percent. Only 63 percent of the alcoholic subjects and alcohol abusers were detected by their physicians, and in only 24 percent of these cases did a physician address the problem with the patient. The CAGE questionnaire is a simple, sensitive, and specific screening test for alcohol abusers.

Alcoholism↗

Validity of a risk-related patient-administered medical questionnaire for dental patients.

In this study the validity of a patient-administered risk-related medical questionnaire for dental patients was tested. The answers given on the questionnaire were compared with the results of a verbal history taken by a physician. This verbal history was considered the "gold standard." The sensitivity and specificity of the medical questionnaire appeared to be sufficiently high, and the kappa values of the separate questions were satisfactory. The questionnaire was found to be valid in the registration of medical problems in dental patients, but combination of the two methods is recommended.

Adult↗

Assessment of chronic pain. II. Problems in the selection of relevant questionnaire items for classification of pain and evaluation and prediction of therapeutic effects.

For the description of pain and for the assessment of treatment pain questionnaires are widely employed but few attempts have been made to study systematically the reliability, validity and clinical usefulness of this tool. In the present study a pain questionnaire composed of questions commonly in use was applied to a group of chronic pain patients, and the results were analysed in order to assess the relevance of each individual item for (a) classification of pain, (b) evaluation of treatment, and (c) prediction of outcome. It was found that the usefulness of the items differed markedly in these three respects. Several of the questions yielded classificatory and predictive information whereas only a few seemed to be suitable for evaluation of outcome of treatment. These results indicate that the selection of items must be made with regard to the special purpose for which the pain questionnaire is intended. The present study may serve as a model for how to proceed in designing a pain questionnaire.

Adult↗

The development of a Norwegian pain questionnaire.

The study was undertaken to develop a multidimensional measuring instrument for pain in the Norwegian language. The McGill Pain Questionnaire (MPQ) was used as a model as it is a valid and reliable tool for pain measurement in English speaking countries. A series of steps were taken to develop a Norwegian pain questionnaire: (1) words describing pain were derived from 95 subjects (patients, students and health personnel); (2) 10 subjects allocated pain descriptors into groups; (3) 36 college student validated the word groupings; (4) 72 patients graded the words contained in each group according to intensity; and (5) the reliability of group items was tested. The study demonstrated that there are many descriptors of pain in the Norwegian language. The final version of the Norwegian pain questionnaire consisted of 106 pain descriptors divided into 18 groups. Validity of the classifications as well as reliability of the words was demonstrated. The actual value of the Norwegian pain questionnaire as a measuring instrument has not yet been documented.

Adolescent↗

Family history of problem drinking among young male social drinkers: reliability of the Family Tree Questionnaire.

The test-retest reliability of the Family Tree Questionnaire to detect drinking problems of family members was examined in a sample of 60 male volunteer university undergraduates. The Questionnaire was completed twice. The first occasion employed a group administration procedure, and an average of 4 months later it was readministered on an individual basis. Thus the length of time and the different administration procedures provided an extreme test of the reliability of the Questionnaire. Test-retest scores of the number of problem drinkers reported by a subject were significantly correlated for first degree and for second degree relatives. The reliability of the classification of an individual family member was also satisfactory. The Family Tree Questionnaire thus appears to be a potentially useful, reliable tool for assessing the incidence of problem drinkers within families of young male social drinkers.

Adult↗

The reliability and validity of the WHO student drug-use questionnaire among Nigerian students.

The reliability and validity of the World Health Organization student drug-use survey model questionnaire was tested among 96 senior secondary school students in the Abeokuta Local Government Area of Ogun State, Nigeria. The exercise was the major theme of a pilot study of a student drug-use survey carried out in this area. The test-retest interval was 4 weeks. The questionnaire was found to be reliable when group and individual (item by item) comparisons were made. The validity scores were also comparable to those of widely accepted previous studies. It was concluded that the questionnaire is reliable and valid enough for use in this environment to allow for comparisons. It can also yield better results if slightly modified and when respondents become more familiar with questionnaire surveys.

Adolescent↗

Comparison of a supplemented Rose Questionnaire to exercise thallium testing in men and women.

The Rose Questionnaire has had high specificity and variable sensitivity when compared to physician identification of the symptom complex of angina pectoris. We assessed the accuracy of a supplemented Rose Questionnaire in a series of 198 patients by comparing the Questionnaire to exercise thallium test evidence of coronary artery disease. The Rose diagnosis of angina had 26% sensitivity, 79% specificity, 42% positive predictive value, and 65% negative predictive value. The Rose diagnosis of myocardial infarction had 26% sensitivity and 90% specificity. The Rose diagnosis of angina or infarction yielded a sensitivity of 44%, specificity of 72%, positive predictive value of 67%, and negative predictive value of 50%. Supplemental questions designed to identify atypical ischemic pain led to increased sensitivity of up to 68% that was offset by decreased specificity. While the Questionnaire's sensitivity for coronary disease was greater for women than men (57 vs 40%), the overall accuracy was the same because specificity was lower (63 vs 80%).

Angina Pectoris↗

Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items.

To evaluate the reproducibility of a quantitative food frequency questionnaire (FFQ) used in a case-control study on cancer of the breast, ovary and digestive tract, we compared the result of a 98-item questionnaire administered twice at an interval of 3-10 months (median = 5.4 months) to 452 volunteers (144 males and 308 females, median age = 50 years) from three Italian provinces (Pordenone, Genoa and Forlí). Spearman correlation coefficients (r) for intake frequency of 87 dietary items ranged from 0.35 ("chicken or turkey, boiled") to 0.84 ("wine"). Most coefficients were between 0.60 and 0.80, only two being below 0.40 and five equal or above 0.80 (mean r = 0.59). The concordance of the two measurements tended to be somewhat better for alcoholic and non-alcoholic beverages, bread, cereals and first courses, fruits and summary questions at the end of each section of the questionnaire than for side dishes, sweets and desserts. Also, the reproducibility of 11 subjective questions, such as those concerning the amount of fat in seasoning and the intake of garlic or salt, seemed to be high. Age, sex, educational level of the volunteers and interval between the two FFQ did not have a large or systematic impact on the concordance of the two measurements. In conclusion, the present study has shown a good level of reproducibility of our questionnaire and has provided a few important hints on ways of improving the description of various food items.

Adult↗

Repeatability of nutrient intakes estimated by a semiquantitative food frequency questionnaire in elderly subjects.

In order to evaluate the repeatability of nutrient values estimated from a semiquantitative food frequency questionnaire being used in a longitudinal study of the relationships between diet, hemostatic factors, and stroke risk in the elderly in Western Sydney, a subsample of 62 participants (24 men, 38 women) completed a repeat questionnaire approximately 1 month after baseline data were collected. The mean age was 78 years (range, 65 to 88; median, 78). Nutrient values calculated from the repeat questionnaire were not significantly different from the baseline results by paired t test. Intraclass correlation coefficients ranged from 0.63 for beta carotene to 0.82 for saturated fat. Quadratic weighted kappa values were calculated for quintile categories and these ranged from 0.50 for fiber to 0.86 for ethanol. These values are comparable to previously published results in elderly subjects and confirm that repeatability of nutrient intakes estimated using semiquantitative food frequency questionnaires is very high in the elderly. Older subjects may be more established in their dietary habits than younger subjects, so any tendency for repeatability to decrease due to impaired memory associated with advanced age is offset by a lower intraindividual variability in dietary habit.

Aged↗

A semiquantitative dietary history questionnaire for Chinese Americans.

An 84-item, semiquantitative dietary history questionnaire was developed for epidemiologic studies of diet and diseases in Chinese Americans. The questionnaire is a 30-minute, face-to-face administered instrument designed especially for assessing mixed dishes; it consists of a food list and requires information on frequency of consumption and portion estimation. A nutrient database was compiled from many sources, but mostly from US Department of Agriculture publications. The relative validity of this food frequency questionnaire was tested among 74 Chinese women between the ages of 30 and 60 years living in the San Francisco Bay area against a 1-day recall deemed a typical day's diet. Correlation coefficients of nutrients from both methods ranged from 0.2 for total fat to 0.7 for calcium and were all statistically significant at less than the 0.001 level. Agreement between these two methods was assessed by the percentage of misclassification of quartile distributions. Around 10% were grossly misclassified and 50% were correct estimates of intake in the same highest quartile, while 73% were correctly placed in the two highest quartiles. This food frequency questionnaire can reasonably estimate the usual dietary intakes among Chinese Americans for epidemiologic studies, but further validation would be needed.

Adult↗

Investigating the factor structure of the Questionnaire on Smoking Urges-Brief (QSU-Brief).

This study was designed to investigate the proposed two-factor structure of the 10-item Questionnaire on Smoking Urges-Brief (QSU-Brief) and to provide evidence for the psychometric properties of this questionnaire using the seven-point scoring set from the original QSU study [Tiffany, S.T., Drobes, D.J. (1991). The development and initial validation of a questionnaire on smoking urges. British Journal of Addiction, 86, 1467-1476.]. The study sample (N=576) was comprised of smokers presenting for treatment. Although an initial exploratory factor analysis appeared to replicate the original factor analytic findings of Cox et al. [Cox, L.S., Tiffany, S.T., Christen, A.G. (2001). Evaluation of the brief questionnaire of smoking urges (QSU-Brief) in laboratory and clinical settings. Nicotine and Tobacco Research, 3, 7-16.], when subjected to confirmatory factor analyses, a five-item, two-factor model using the most robust items from the original QSU-Brief factor analysis was the best explanation of the data in the present study. Good internal consistency reliability estimates were also obtained with this model. These results suggest that this shortened form of the QSU-Brief can be used with the original seven-point scoring set as a reliable assessment of the dual nature of smoking urges in a treatment-seeking population.

Adult↗

Comparing electronic-keypad responses to paper-and-pencil questionnaires in group assessments of alcohol consumption and related attitudes.

Electronic versions of questionnaires have the potential to improve research and interventions in the addictions. Administering questionnaires electronically to groups, however, has proven difficult without a multitude of computers, but gathering data electronically from a group could make for easy assessment and quick feedback. Using a sample of 107 college students, we examined the validity of wireless keypad survey responses by comparing them to traditional paper-and-pencil questionnaires. The two formats led to almost identical responses that did not differ significantly from each other (all effect sizes less than g=.15) and high correlations between formats. The wireless, handheld keypad procedure appears to generate data that are as valid as questionnaire responses and permit rapid feedback to groups, as well as easy, human error-free data entry for analysis.

Adult↗

Describing pain with physical disability: narrative interviews and the McGill Pain Questionnaire.

OBJECTIVES: To identify common pain descriptors used by people with physical disability-related pain and to suggest words that are likely to prompt responses in clinical interviews and assessments. DESIGN: Open-ended interviews were coded and then contrasted with responses to a pain questionnaire, obtained through mail or interview surveys. SETTING: Rehabilitation research program. PARTICIPANTS: Twenty-eight people with physical disability-related pain in a series (n=54) of in-depth interviews and 1053 participants with disabilities who responded to mailed questionnaires or structured interviews about pain and its impact (459 with acquired lower-limb amputation, 471 with spinal cord injury, 123 with cerebral palsy). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Pain interview descriptions and McGill Pain Questionnaire (MPQ). RESULTS: Different pain experiences were reflected in narrative descriptions and self-report questionnaire responses. We report the common terms, but across diagnoses use of terms does not appear to clearly differentiate distinct pain phenomenon. Narrative interviews support the use of several MPQ pain descriptors. However, discrete descriptors are recommended when assessing adults with physical disability. CONCLUSIONS: We identified pain descriptors that appear to be most useful in assessing daily life and participation experiences with physical disability-related pain. These may be clinically useful, but caution is advised when doing diagnostic workups based solely on sensory and affective pain descriptions.

Adult↗

Measurement of dietary restraint: validity tests of four questionnaires.

This study tested the validity of four measures of dietary restraint: Dutch Eating Behavior Questionnaire, Eating Inventory (EI), Revised Restraint Scale (RS), and the Current Dieting Questionnaire. Dietary restraint has been implicated as a determinant of overeating and binge eating. Conflicting findings have been attributed to different methods for measuring dietary restraint. The validity of four self-report measures of dietary restraint and dieting behavior was tested using: (1) factor analysis, (2) changes in dietary restraint in a randomized controlled trial of different methods to achieve calorie restriction, and (3) correlation of changes in dietary restraint with an objective measure of energy balance, calculated from the changes in fat mass and fat-free mass over a six-month dietary intervention. Scores from all four questionnaires, measured at baseline, formed a dietary restraint factor, but the RS also loaded on a binge eating factor. Based on change scores, the EI Restraint Scale was the only measure that correlated significantly with energy balance expressed as a percentage of energy required for weight maintenance. These findings suggest that, of the four questionnaires tested, the EI Restraint Scale was the most valid measure of the intent to diet and actual caloric restriction.

Adult↗

Reliability and validity of the Health Outcomes Burn Questionnaire for infants and children in The Netherlands.

The Health Outcomes Burn Questionnaire (HOBQ) is a self-administered questionnaire to monitor outcome after burns in young children. This study aimed to assess feasibility, reliability and validity of the Dutch version of the HOBQ. The HOBQ was adapted into Dutch and tested in a population of children aged 0-4 years with a primary admission to a Dutch burn centre in March 2001-February 2004. Parents of 413 children were sent a questionnaire. To assess validity, a generic outcome instrument was included, the Infant Toddler Quality of Life Questionnaire (ITQOL). The response rate was 50.0% (n=196). Mean self-reported completion time was 16.7 min. The internal consistency of all the HOBQ-scales was good (Cronbach's alpha's>0.69). Test-retest results showed no differences in 7 out of 10 scales. High correlations between HOBQ-scales and conceptually equivalent ITQOL and scales were found in 5 out of 7 comparisons. The majority of the HOBQ-scales (7 out of 10) showed significant differences in the expected direction between children with a long versus short length of stay. Our data support the reliability and validity of the Dutch HOBQ. The HOBQ can be used as a research tool, to monitor functional outcome after burns in young children. Further research in other samples is recommend to fully establish the reliability and validity of the HOBQ.

Burns↗

Factor structure and reliability of the Childhood Trauma Questionnaire in a Canadian undergraduate student sample.

OBJECTIVE: The aims of this study were to examine (1) the psychometric properties of the Childhood Trauma Questionnaire [CTQ; Bernstein, D., Fink, L., Handelsman, L., Foote, J., Lovejoy, M., Wenzel, K., Sapareto, E., & Ruggiero, J. (1994). Initial reliability and validity of a new retrospective measure of child abuse and neglect. American Journal of Psychiatry, 151, 1132-1136; Bernstein, D., & Fink, L. (1993). Manual for the Childhood Trauma Questionnaire. Unpublished manuscript. Bronx, NY: VA Medical Center] in an undergraduate sample and (2) the prevalence of abuse and neglect in this sample. METHOD: Principal components analyses (PCA), coefficient alpha, and correlations were used to analyse data for 470 undergraduate students from a mid-western Canadian university. Cut-offs from a short-form of the CTQ [Bernstein, D., & Fink, L. (1998). Manual for the Childhood Trauma Questionnaire. New York: The Psychological Corporation] were used to estimate prevalence. RESULTS: PCA yielded a five-factor solution comprised of emotional, physical, and sexual abuse, as well as emotional, and physical neglect. All factors, except physical neglect, demonstrated good internal consistency and test-retest reliability. This factor structure largely replicated results reported for an adolescent clinical sample [Bernstein, D., Ahluvala, T., Pogge, D., & Handelsman, L. (1997). Validity of the Childhood Trauma Questionnaire in an adolescent psychiatric population. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 340-348], with the exception of the physical neglect factor which was comprised of considerably different items. Rates of childhood trauma were largely comparable to those reported for community and student samples in more densely populated regions of North America. CONCLUSIONS: The CTQ appears to be a valid measure of abuse and neglect in student samples, although experiences are somewhat differentially identified as different types of abuse and neglect depending on age and patient versus nonpatient status.

Adolescent↗

The eating disorder belief questionnaire: psychometric properties in an adolescent sample.

The current study aimed to investigate the psychometric properties of the Eating Disorder Belief Questionnaire in older adolescent females. Three hundred and sixty-seven girls aged 17 or 18 who were in secondary school education completed the Eating Disorder Belief Questionnaire, the Beck Depression Inventory and the Eating Attitudes Test. They also provided information on height and weight. The Eating Disorder Belief Questionnaire had an almost identical factor structure to that previously found in adult women, although the factors were not quite as discrete as those in the original validation study. Internal consistency for each factor was high and construct validity (including convergent and criterion related validity) was very good. The almost identical factor structure, and other good psychometric properties, found for the Eating Disorder Belief Questionnaire in the current study suggests that it is an appropriate measure for use in clinical settings and in research studies involving 17-18 year old girls. This includes older adolescents with eating disorders. The possibility that adolescents show a developmental tendency for less separation between the constructs assessed, when compared with adults, is of particular interest, and requires further exploration.

Adolescent↗

Validation of self assessment patient knowledge questionnaire for heart failure patients.

BACKGROUND: Several studies showed insufficient knowledge and poor compliance to non-pharmacological management in heart failure patients. Only a limited number of validated tools are available to assess their knowledge. The aim of the study was to test our 10-item Patient knowledge questionnaire. METHODS: The Patient knowledge questionnaire was administered to 42 heart failure patients from Heart failure clinic and to 40 heart failure patients receiving usual care. Construct validity (Pearson correlation coefficient), internal consistency (Cronbach alpha), reproducibility (Wilcoxon signed rank test), and reliability (chi-square test and Student's t-test for independent samples) were assessed. RESULTS: Overall score of the Patient knowledge questionnaire had the strongest correlation to the question about regular weighing (r=0.69) and the weakest to the question about presence of heart disease (r=0.33). There was a strong correlation between question about fluid retention and questions assessing regular weighing, (r=0.86), weight of one litre of water (r=0.86), and salt restriction (r=0.57). The Cronbach alpha was 0.74 and could be improved by exclusion of questions about clear explanation (Chronbach alpha 0.75), importance of fruit, soup, and vegetables (Chronbach alpha 0.75), and self adjustment of diuretic (Chronbach alpha 0.81). During reproducibility testing 91% to 98% of questions were answered equally. Patients from Heart failure clinic scored significantly better than patients receiving usual care (7.9 (1.3) vs. 5.7 (2.2), p<0.001). CONCLUSIONS: Patient knowledge questionnaire is a valid and reliable tool to measure knowledge of heart failure patients.

Ambulatory Care Facilities↗