Pugliatti M, Casetta I, Drulovic J, Granieri E, Holmøy T, Kampman M T, Landtblom A-M, Lauer K, Myhr K-M, Parpinel M, Pekmezovic T, Riise T, Zhu B, Wolfson C
Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
Acta Neurol Scand Suppl. 2012(195):43-50. doi: 10.1111/ane.12032.
The increasing incidence of multiple sclerosis (MS) worldwide, especially in women, points to the crucial role of environmental and lifestyle risk factors in determining the disease occurrence. An international multicentre case-control study of Environmental Risk Factors In Multiple Sclerosis (EnvIMS) has been launched in Norway, Sweden, Italy, Serbia and Canada, aimed to examine MS environmental risk factors in a large study population and disclose reciprocal interactions. To ensure equivalent methodology in detecting age-related past exposures in individuals with and without MS across the study sites, a new questionnaire (EnvIMS-Q) is presented.
EnvIMS-Q builds on previously developed guidelines for epidemiological studies in MS and is a 6-page self-administered postal questionnaire. Participants are de-identified through the use of a numerical code. Its content is identical for cases and controls including 'core' and population-specific questions as proxies for vitamin D exposure (sun exposure, dietary habits and supplementation), childhood infections (including infectious mononucleosis) and cigarette smoking. Information on possible confounders or effect modifiers is also obtained. EnvIMS-Q was initially drafted in English and subsequently translated into Italian, Serbian, Norwegian, Swedish and French-Canadian. EnvIMS-Q has been tested for acceptability, feasibility and reliability.
EnvIMS-Q has shown cross-cultural feasibility, acceptability and reliability in both patients with MS and healthy subjects from all sites. EnvIMS-Q is an efficient tool to ensure proper assessment of age-specific exposure to environmental factors in large multinational population-based case-control studies of MS risk factors.
全球范围内多发性硬化症（MS）的发病率不断上升，尤其是在女性中，这表明环境和生活方式风险因素在决定疾病发生方面起着关键作用。在挪威、瑞典、意大利、塞尔维亚和加拿大发起了一项关于多发性硬化症环境风险因素的国际多中心病例对照研究（EnvIMS），旨在在一个大型研究人群中研究MS的环境风险因素并揭示相互作用。为确保在各研究地点对患有和未患有MS的个体检测与年龄相关的既往暴露情况时采用等效方法，提出了一份新问卷（EnvIMS-Q）。
EnvIMS-Q基于先前制定的MS流行病学研究指南，是一份6页的自填式邮寄问卷。通过使用数字代码对参与者进行身份识别。其内容对病例和对照相同，包括作为维生素D暴露（阳光暴露、饮食习惯和补充剂）、儿童期感染（包括传染性单核细胞增多症）和吸烟代理指标的“核心”问题及特定人群问题。还获取了关于可能的混杂因素或效应修饰因素的信息。EnvIMS-Q最初用英语起草，随后被翻译成意大利语、塞尔维亚语、挪威语、瑞典语和加拿大法语。EnvIMS-Q已针对可接受性、可行性和可靠性进行了测试。
EnvIMS-Q在所有研究地点的MS患者和健康受试者中均显示出跨文化的可行性、可接受性和可靠性。EnvIMS-Q是一种有效的工具，可确保在基于人群的大型跨国MS危险因素病例对照研究中对特定年龄的环境因素暴露进行恰当评估。
