Mahalingaiah Shruthi, Cosenza Carol, Cheng J Jojo, Rodriguez Erika, Aschengrau Ann
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1 665 Huntington Avenue, Boston, MA, 02115, USA.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital , 55 Fruit Street Yawkey 10, Boston, MA, 02114, USA.
Fertil Res Pract. 2020 Nov 9;6(1):19. doi: 10.1186/s40738-020-00088-x.
In large population-based studies, there is a lack of existing survey instruments designed to ascertain menstrual cycle characteristics and androgen excess status including hirsutism, alopecia, and acne. Our objective was to cognitively test a survey instrument for self-assessed menstrual cycle characteristics androgen excess.
Questions to assess menstrual characteristics and health were designed using existing surveys and clinical experience. Pictorial self-assessment tools for androgen excess were also developed with an experienced medical illustrator to include the modified Ferrimen-Galway, acne and androgenic alopecia. These were combined into an online survey instrument using REDCap. Of the 219 questions, 120 were selected for cognitive testing to assess question comprehension in a population representative of the future study population.
Cognitive testing identified questions and concepts not easily comprehended, recalled, or had problematic response choices. Comprehension examples included simplifying the definition for polycystic ovary syndrome and revising questions on historic menstrual regularity and bleeding duration. Recall and answer formation examples include issues with recalling waist size, beverage consumption, and interpretation of questions using symbols (> or <). The survey was revised based on feedback and subsequently used in the Ovulation and Menstruation (OM) Health Pilot study.
We present a cognitively tested, novel survey instrument to assess menstrual cycle characteristics and androgen excess.
在基于大规模人群的研究中，缺乏旨在确定月经周期特征和雄激素过多状态（包括多毛症、脱发和痤疮）的现有调查工具。我们的目标是对一种用于自我评估月经周期特征和雄激素过多情况的调查工具进行认知测试。
利用现有调查和临床经验设计了评估月经特征和健康状况的问题。还与一位经验丰富的医学插画家共同开发了用于雄激素过多情况的图片自我评估工具，包括改良的费里曼-盖尔维评分法、痤疮和雄激素性脱发。这些内容使用REDCap整合到一个在线调查工具中。在219个问题中，选取了120个进行认知测试，以评估未来研究人群代表性样本对问题的理解情况。
认知测试发现了一些不易理解、回忆或存在有问题的回答选项的问题和概念。理解方面的例子包括简化多囊卵巢综合征的定义以及修改关于既往月经规律和出血持续时间的问题。回忆和回答形成方面的例子包括回忆腰围、饮料摄入量以及对使用符号（>或<）的问题的理解等问题。根据反馈对调查进行了修订，随后用于排卵与月经（OM）健康试点研究。
我们展示了一种经过认知测试的新型调查工具，用于评估月经周期特征和雄激素过多情况。
