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Comparison of questionnaires: the BMRC and NHLI respiratory questionnaires and a new self-completion questionnaire.

Interviewer-administered National Heart and Lung Institute (NHLI) and British Medical Research Council (BMRC) respiratory questionnaires were compared with each other and with a self-administered questionnaire of our own design in 2,350 adults enrolled in a longitudinal community study. There was a basic 10% disagreement between responses to any 2 questionnaires for all questions that inquired about a perception of a complaint or a disease, but much less disagreement for more factual questions, such as those concerning smoking. Little effect was noted from minor variations in wording, order of questions, method of administration, inclusion of other questions, or time between questionnaires (as long as this interval was less than 1 month). For questions with similar wording, the BMRC and NHLI questionnaires yielded very similar results in terms of over-all prevalence of responses, relationships to answers on an independent questionnaire, and inter-relationships of positive responses. The new self-completion questionnaire used in this study detected more abnormalities and better delineated cough and phlegm "syndromes" than either the NHLI or the BMRC questionnaire, and we believe that self-administration was a very satisfactory technique in the type of population surveyed in this study.

Adult

[Evaluation of the self-administered respiratory questionnaire recommended by the Japanese Labour Ministry based on the standardized interviewer-administered BMRC questionnaire].

The self-administered respiratory questionnaire on persistent cough or sputum prepared and recommended by the Japanese Labour Ministry to detect pneumoconiosis was evaluated and compared with the Japanese version of the standardized interviewer-administered respiratory questionnaire developed by the British Medical Research Council (BMRC). The two questionnaires were given to 800 subjects on the same day. Because the wording of the questions was similar, the two questionnaires yielded very similar results. In terms of the overall prevalence of persistent cough or sputum, no important differences could be demonstrated between the results of the two questionnaires. The results of this study indicate that the self-administered questionnaire has good concordance with the BMRC questionnaire. When compared to the BMRC questionnaire, the specificity of the self-administered questionnaire was found to be more than 99%, but the sensitivity was inferior to the specificity, being less than 80%. When confined to subjects with persistent cough or sputum for two years or more, the sensitivity was up to 84%. These findings suggest the responses of the subjects to the self-administered questionnaire tend to be negative. A validity of the self-administered questionnaire needs to be further studied among dust workers including pneumoconiotics.

Adult

The Edinburgh Claudication Questionnaire: an improved version of the WHO/Rose Questionnaire for use in epidemiological surveys.

The WHO/Rose Questionnaire on intermittent claudication was developed in 1962 for use in epidemiological surveys, and has been widely used. Several population studies have shown, however, that it is only moderately sensitive (60-68%), although highly specific (90-100%). In this study, reasons for the poor sensitivity and good specificity were determined following its application to 586 claudicants and to 61 subjects with other causes of leg pain. The results showed two important findings: firstly, that over half of the false negatives were produced by one question alone; and secondly that only three questions were required to maintain the specificity of the questionnaire. This knowledge, in conjunction with the pre-testing of additional questions, enabled a new questionnaire to be constructed: the "Edinburgh Claudication Questionnaire". This questionnaire was tested on 300 subjects aged over 55 years attending their general practitioner, and found to be 91.3% (95% CI 88.1-94.5%) sensitive and 99.3% (95% CI 98.9-100%) specific in comparison to the diagnosis of intermittent claudication made by a physician. The repeatability of the questionnaire after 6 months was excellent (kappa = 0.76, p < 0.001). These results suggest that this revised version of the WHO/Rose Questionnaire should be adopted for use in future epidemiological surveys of peripheral vascular disease.

Aged

Retrospective information from questionnaires. II. Intrarater reliability and comparison of questionnaire types.

Medical and dietary consumption histories obtained at two times from cases or controls and their next-of-kin as part of a study of colon cancer in the five Pennsylvania counties of the Philadelphia metropolitan area were compared. The case population was confined to whites aged 45-69 years who had resided in the region for at least two years prior to diagnosis and were diagnosed with colon cancer after July 1, 1976. Controls were selected using an area probability sampling scheme and were frequency-matched to the case group. Questionnaires for randomly selected subsamples of cases and controls were administered by interviewers; questionnaires for next-of-kin were randomly allocated to be self- or interviewer-administered. Agreement when respondents received the interviewer-administered questionnaire at both interviews was greater than when the self-administered questionnaire was used. Medical variables exhibited high agreement, the percentage agreement exceeded 80 for over 80% of the comparisons, the kappa statistic exceeded 0.6 for half of the comparisons. Diet histories were more variable (average agreement ranging from 56% to 67% and average kappa values from 0.16 to 0.40 for the different comparisons).

Beverages

Comparison of a video questionnaire with the IUATLD written questionnaire for measuring asthma prevalence.

A video questionnaire (VQ) for measuring asthma prevalence in adolescents was assessed for repeatability and validity in relation to bronchial hyperresponsiveness (BHR) (PD20 less than or equal to 7.8 mumol methacholine). Comparison was also made with a standard, self completed written questionnaire (SQ), based on the IUATLD Bronchial Symptoms Questionnaire, which included five questions seeking comparable data to those in the VQ. Both the VQ and SQ were administered to 707 schoolchildren (13-16 years), in whom English was the primary language. One hundred and six randomly selected children subsequently underwent bronchial challenge to methacholine. Both the sensitivity and specificity for BHR were higher for a combination of three or more positive responses to the VQ (0.73 and 0.88), than to the SQ (0.63 and 0.82), although these differences were not statistically significant (P = 0.24). When administered again after a two week interval, the VQ had a significantly higher (P = 0.03) coefficient of repeatability (0.79) than the SQ (0.50). We conclude that the VQ is a valid and reliable method of determining asthma prevalence, and propose that by providing data relatively free from biases due to language, culture, literacy or interviewing techniques it may be particularly useful when comparing asthma prevalence and severity in different populations.

Adolescent

Chiropractic chronic low back pain sufferers and self-report assessment methods. Part II. A reliability study of the Middlesex Hospital Questionnaire and the VAS Disability Scales Questionnaire.

The subjective complaints of 41 chronic low back pain sufferers attending a chiropractic clinic were assessed twice prior to therapy with a widely used psychological self-report assessment tool, the Middlesex Hospital Questionnaire (MHQ) and a newly developed VAS Disability Scales Questionnaire (DISQ), both of which investigate various aspects of certain basic positions and activities. Reliability was generally acceptable with these two questionnaires. Subjects participating in the study were commonly found to score within the normal range on the MHQ, indicating that psychological disturbance was not a major feature of their presentation. However, mild mood disturbance was commonly reported, and a more sensitive tool may need to be developed for this type of mildly affected chronic low back pain sufferers. The DISQ generally indicated subjects were mildly to moderately affected by their low back trouble and that sitting and leisure activities were the most pain provoking. Recommendations for further development of the disability scale are made.

Back Pain

Factor structures of the Home Situations Questionnaire and the School Situations Questionnaire.

Examined the factor structures of the Home Situations Questionnaire (HSQ) and the School Situations Questionnaire (SSQ). The sample included 955 (505 boys, 490 girls) ages 4 through 11 years old. Separate principal components factor analysis with Varimax rotations were computed for the HSQ and the SSQ. For the HSQ, four factors emerged, accounting for 57% of the variance. For the SSQ, three factors emerged, accounting for 71% of the variance. Factors are briefly discussed. Factor means, standard deviations, and significant cutoff points are provided for clinical use.

Analysis of Variance

Comparison of the General Health Questionnaire and the Cornell Medical Index Health Questionnaire.

This study compares the 30-item version of the General Health Questionnaire (GHQ) and the psychiatric section of the Cornell Medical Index Health Questionnaire (CMI-MR) using normative data from a sample of the general population and data from general practice patients where clinical assessment by a psychiatrist is used as a criterion of psychiatric caseness. In this study the CMI-MR has a slightly better overall performance as a screening test. It appears that the CMI-MR errs in the direction of false negatives when the symptoms are recent and related to situational stress, but the GHQ has a tendency to miss cases with symptoms of long standing.

Adult

Diagnostic utility of the McGill Pain Questionnaire and the Oswestry Disability Questionnaire for classification of low back pain syndromes.

Verbal pain description and assessment of functional limitations are key components in the clinical evaluation of patients with low back pain syndromes. Using the McGill Pain Questionnaire (MPQ) to quantify the pain experience and the Oswestry Disability Questionnaire (ODQ) to quantify functional disability, a study was undertaken to determine the efficiency with which the MPQ and ODQ were capable of enhancing the differential diagnosis of three broad categories of low back syndromes. Three discriminative models were employed. The combined discriminant model (MPQ/ODQ) yielded the highest accuracy, 0.90, and it was the only model with acceptable predictive power. The greatest utility of the discriminant models was found to be ruling out nonspecific low back pain and ruling in radiculopathy, with and without neurological deficits. Subjective pain and disability appear to have the potential for successfully differentiating broad categories of low back pain. Further studies need to be performed to assess the discriminant power of the MPQ and ODQ for specific diagnostic entities.

Activities of Daily Living

[Population contacts in the Republic of Guinea with ectoparasites and rodents based on questionnaire data. 1. The tasks and the scope of the questionnaire].

Questionnaire is presented which was used in 1987 in 15 regions (28,400 inhabitants) of 3 landscape climatic areas in Guinea: savanna-forest, light and damp tropical forests. The questionnaire was aimed at obtaining quantitative characteristics on important items of population economic activity and number of potential hosts and carriers of natural focus infections in the buildings. Types of the population occupation were differentiated in conformity with various biotopes the people belong to, and according to their direct contacts with domestic, synanthropic and wild animals. The quantity of little mammals (multi-nipple, gray, black and hamster--like rats, mice, shrews, and bats) and ectoparasites (bloodsucking Ixodes, fleas and lice) and intensity of control thereof were estimated according to 4 grades in 6 types of residential and uninhabited constructions.

Africa, Western