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自我报告病史的一致性:面对面访谈与自填式问卷的比较

Agreement of self-reported medical history: comparison of an in-person interview with a self-administered questionnaire.

作者信息

Bergmann Manuela M, Jacobs Eric J, Hoffmann Kurt, Boeing Heiner

机构信息

Department of Epidemiology, German Institute of Human Nutrition, Bergholz-Rehbruecke, Germany.

出版信息

Eur J Epidemiol. 2004;19(5):411-6. doi: 10.1023/b:ejep.0000027350.85974.47.

Abstract

PURPOSE

To compare history of 22 different diseases reported during an in-person interview with that reported on a mailed self-administered questionnaire.

METHODS

7841 participants of the European Prospective Investigation into Cancer (EPIC)-Potsdam study. The interview at baseline and the questionnaire at follow-up approximately 2 years later included identical questions about whether the participant had ever had a physician diagnosis of each disease. Incident diagnoses occurring in the interval between the interview and questionnaire were excluded from the analysis.

RESULTS

Agreement between self-report from the interview and from the questionnaire was highest (kappa = 0.83-0.88) for myocardial infarction, cancer and diabetes mellitus; it was lower (kappa = 0.68-0.77) for gout, hypertension, hay fever, asthma, osteoporosis, ulcer of the duodenum, thyroid disease, stroke, and kidney stones, and was lowest (kappa = 0.39-0.59) for chronic gastritis, ulcer of the stomach, cerebral ischemia, benign tumor, inflammatory bowel disease, angina pectoris, hyperlipidemia, rheumatism, colon polyps and skin disease. The poor agreement for less severe or more transient diseases was primarily a result of disease frequently being reported at the interview but not on the questionnaire.

CONCLUSION

Self-administered questionnaires do not generate same information particularly for less severe or transient diseases as personal interviews. For these diseases, self-administered questionnaires are not recommended. Pilot studies that test validity will be necessary.

摘要

目的

比较在面对面访谈中报告的22种不同疾病的病史与通过邮寄的自填式问卷报告的病史。

方法

欧洲癌症前瞻性调查(EPIC)-波茨坦研究的7841名参与者。基线时的访谈和大约两年后的随访问卷包含关于参与者是否曾被医生诊断患有每种疾病的相同问题。分析中排除了在访谈和问卷之间的间隔期出现的新发诊断。

结果

对于心肌梗死、癌症和糖尿病,访谈中的自我报告与问卷中的自我报告之间的一致性最高(kappa = 0.83 - 0.88);对于痛风、高血压、花粉热、哮喘、骨质疏松症、十二指肠溃疡、甲状腺疾病、中风和肾结石,一致性较低(kappa = 0.68 - 0.77);对于慢性胃炎、胃溃疡、脑缺血、良性肿瘤、炎症性肠病、心绞痛、高脂血症、风湿病、结肠息肉和皮肤病,一致性最低(kappa = 0.39 - 0.59)。对于不太严重或更短暂的疾病,一致性较差主要是因为这些疾病在访谈中经常被报告,但在问卷中未被报告。

结论

自填式问卷不能产生与个人访谈相同的信息,尤其是对于不太严重或短暂的疾病。对于这些疾病,不建议使用自填式问卷。有必要进行测试有效性的试点研究。

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