Faculty of Human Movement Sciences, Research Institute MOVE, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT, Amsterdam, The Netherlands,
Int Arch Occup Environ Health. 2013 Oct;86(7):789-98. doi: 10.1007/s00420-012-0809-x. Epub 2012 Sep 7.
The objective was to determine the concurrent validity of questions on arm, shoulder and neck symptoms of an Internet-based questionnaire. In addition, the inter-observer reliability of physical examinations by occupational physicians was investigated.
A total of 160 employees of a Dutch occupational health service were approached, of which 106 participated. Right after the assessment of arm, shoulder and neck symptoms using a self-administered questionnaire, each participant was examined by two occupational physicians. The presence of symptoms in the past 7 days was compared to the physical examinations. The participation of two occupational physicians allowed us to study also the inter-observer reliability.
Overall, the concurrent validity of the symptom questions of the questionnaire can be defined as poor to moderate with κ values between 0.16 and 0.53. Detecting the presence of symptoms (p(pos)) could be considered as moderately valid with values below 0.60, but the p(neg) shows that the concurrent validity for detecting the absence of arm, shoulder or neck symptoms can be considered sufficient with values above 0.69. The agreement between occupational physicians can, with a few exceptions, be considered as moderate with κ values below 0.60. The agreement was sufficient for detecting the absence of symptoms (p(neg) > 0.7).
The agreement between the symptom questions of the questionnaire and physical examinations of occupational physicians can be considered as poor to moderate. The results are comparable to what is generally reported in the literature. Future studies should be aimed at gaining more fundamental knowledge about the possible conceptual differences between self-reported symptoms and symptoms assessed using physical examinations. Moreover, it is advisable to improve the inter-observer reliability of physical examinations as applied in the present study.
旨在确定基于互联网的问卷中手臂、肩部和颈部症状问题的同时效度。此外，还研究了职业医生进行体格检查的观察者间可靠性。
共向荷兰职业健康服务机构的 160 名员工发出邀请，其中 106 名员工参与了研究。在使用自我管理问卷评估手臂、肩部和颈部症状后，每位参与者均由两名职业医生进行检查。将过去 7 天的症状存在情况与体格检查进行比较。两名职业医生的参与使我们能够研究观察者间可靠性。
总体而言，问卷症状问题的同时效度可定义为差到中度，κ 值在 0.16 到 0.53 之间。（p(pos)）可被视为中度有效，值低于 0.60，但（p(neg)）表明，在检测手臂、肩部或颈部症状不存在时，同时效度可以被认为是足够的，值高于 0.69。除了少数例外，职业医生之间的一致性可以被认为是中度的，κ 值低于 0.60。对于检测症状不存在的情况，一致性是足够的（p(neg) > 0.7）。
问卷症状问题与职业医生体格检查之间的一致性可以被认为是差到中度。研究结果与文献中普遍报道的结果相当。未来的研究应旨在获得更多关于自我报告症状与使用体格检查评估症状之间可能存在的概念差异的基础知识。此外，建议提高本研究中应用的体格检查的观察者间可靠性。
