Interviewer versus self-administered questionnaires in developing a disease-specific, health-related quality of life instrument for asthma

doi:10.1016/0895-4356(93)90125-K

Journal of Clinical Epidemiology

Volume 46, Issue 6, June 1993, Pages 529-534

https://doi.org/10.1016/0895-4356(93)90125-K Get rights and content

Abstract

We wished to determine the extent to which respondents provided the same answers to a health-related quality of life (HRQL) questionnaire in self-and interviewer-administered forms. One hundred and fifty patients with asthma who were symptomatic or required treatment at least once a week, and had airway hyperresponsiveness to methacholine aerosol (PC₂₀ < 8.0 mg/ml) participated. Patients completed a 152-item HRQL questionnaire in both interviewer and self-administered forms, separated by a 2-week interval, the order determined by random allocation. The percentage of items endorsed by the self-administered approach was significantly higher than that of the interviewer-administered approach overall (46.9 vs 35.8%) (p < 0.0001). The difference was consistent across all six domains; the absolute difference in the proportion of items endorsed varied from 8.9 to 12.3%. The intraclass correlations for the proportion of subjects endorsing an item was 0.84. Self- and interviewer-adminstered questionnaires yield very similar results in discriminating between subjects, but the self-administered version shows systematically greater HRQL impairment.

References (21)

R. Deyo
Measuring functional outcomes in therapeutic trials for chronic disease
Contr Clin Trials
(1984)
G.H. Guyatt et al.
Quality of life in patients with chronic airflow limitation
Br J Dis Chest
(1987)
G.H. Guyatt et al.
Measuring quality of life in clinical trials: a taxonomy and review
Can Med Assoc J
(1989)
E.F. Juniper et al.
Evaluation of impairment of health-related quality of life in asthma: Development of a questionnaire for use in clinical trials
Thorax
(1992)
E.F. Juniper et al.
Measuring quality of life in asthma
Am Rev Respir Dis
(1993)
G.H. Guyatt et al.
Measuring disease-specific quality of life in clinical trials
Can Med Assoc J
(1986)
R.A. Kinsman et al.
Multidimensional analysis of the subjective symptomatology of asthma
Psychosom Med
(1973)
M. Bergner et al.
The sickness impact profile: development and final revision of a health status measure
Med Care
(1981)
R.H. Brook et al.
Overview of validity and the index of well-being
Health Serv Res
(1976)
E.F. Juniper et al.
Airway responsiveness to histamine and methacholine; relationship to minimum treatment to control symptoms of asthma
Thorax
(1981)

There are more references available in the full text version of this article.

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^†: Drs Jaeschke and Cook are St Joseph's Hospital Foundation Research Fellows, and Drs Guyatt and Cook are Career Scientists with the Ontario Ministry of Health.

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Original articleInterviewer versus self-administered questionnaires in developing a disease-specific, health-related quality of life instrument for asthma

Abstract

Contr Clin Trials

Br J Dis Chest

Measuring quality of life in clinical trials: a taxonomy and review

Can Med Assoc J

Evaluation of impairment of health-related quality of life in asthma: Development of a questionnaire for use in clinical trials

Thorax

Measuring quality of life in asthma

Am Rev Respir Dis

Measuring disease-specific quality of life in clinical trials

Can Med Assoc J

Multidimensional analysis of the subjective symptomatology of asthma

Psychosom Med

The sickness impact profile: development and final revision of a health status measure

Med Care

Overview of validity and the index of well-being

Health Serv Res

Airway responsiveness to histamine and methacholine; relationship to minimum treatment to control symptoms of asthma

Thorax

Original article
Interviewer versus self-administered questionnaires in developing a disease-specific, health-related quality of life instrument for asthma