Limited agreement between written and video asthma symptom questionnaires

Area of Science:

• Epidemiology
• Pediatric Respiratory Medicine
• Allergy and Immunology

Background:

• Accurate asthma prevalence determination is challenging due to the lack of a definitive diagnostic standard.
• Video questionnaires offer a novel approach for epidemiological studies, reducing reliance on written comprehension.
• The International Study of Asthma and Allergies in Childhood (ISAAC) developed video questionnaires to assess asthma symptoms.

Purpose of the Study:

• To evaluate the agreement between ISAAC written and video questionnaires regarding respiratory symptoms and reported asthma.
• To compare asthma prevalence rates derived from written versus video questionnaire responses.

Main Methods:

• 4952 children aged 13-14 years in two Canadian communities completed both ISAAC written and video questionnaires sequentially.
• Agreement was assessed for various wheeze symptoms (ever, current, exercise-induced, nocturnal) and diagnosed asthma using concordance and kappa coefficients.
• Analysis included the full sample and subgroups reporting diagnosed asthma.

Main Results:

• Video questionnaire responses yielded significantly lower prevalence rates for all assessed asthma symptoms compared to written questionnaires.
• Concordance between video and written questionnaires exceeded 60-70% for related questions.
• Agreement, measured by kappa statistic, ranged from fair to moderate (kappa = 0.22-0.51).

Conclusions:

• The ISAAC video questionnaire results in lower reported prevalence rates for asthma symptoms.
• Limited agreement exists between the video and written questionnaires, independent of language, culture, or literacy factors.
• Further research is needed to validate the utility of video questionnaires in asthma epidemiology.