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Reproducibility of childhood respiratory symptom questions
B Brunekreef1, B Groot, B Rijcken
1Dept of Epidemiology and Public Health, University of Wageningen, The Netherlands.
Insights
This study assessed childhood respiratory symptom questionnaire reproducibility in Dutch school children. Questions on wheeze, asthma, bronchitis, and pneumonia showed good to excellent reliability, unlike those for cough and runny nose.
Area of Science:
- Pediatric respiratory health
- Epidemiology
- Clinical assessment
Background:
- Childhood respiratory symptoms are common and require reliable assessment tools.
- Existing questionnaires vary in their development and validation.
- Standardizing symptom reporting is crucial for accurate diagnosis and research.
Purpose of the Study:
- To evaluate the reproducibility of answers to two childhood respiratory symptom questionnaires.
- To compare the reliability of questions from the World Health Organization (WHO) and Child Health Care (CHC) questionnaires.
- To identify specific symptoms with high and low reproducibility in pediatric populations.
Main Methods:
- Administered WHO and CHC questionnaires twice to parents of 410 Dutch school children (6-12 yrs) over one month.
- Assessed reproducibility using Cohen's Kappa statistic.
- Investigated the influence of questionnaire order, child's gender/age, and parental factors.
Main Results:
- Questions on "wheeze", "asthma", "bronchitis", "cough and phlegm", and "pneumonia" demonstrated good to excellent reproducibility (Kappa 0.60-0.96).
- Questions regarding "phlegm", "cough", "chest congestion", and "runny/congested nose" showed lower reproducibility (Kappa < 0.60).
- Reproducibility was not affected by questionnaire order, child demographics, or parental characteristics.
Conclusions:
- Specific childhood respiratory symptoms like wheeze and asthma can be reliably reported by parents using validated questionnaires.
- Symptoms such as isolated cough or nasal congestion may require more nuanced assessment methods for consistent reporting.
- The findings support the use of certain symptom questions for epidemiological studies and clinical evaluations in children.
Abstract:
The reproducibility of answers to childhood respiratory symptom questions was investigated by administering two childhood respiratory symptom questionnaires twice, with a one month interval, to the same population of Dutch school children. The questionnaires were completed by the parents of 410 children from 6-12 yrs old. One questionnaire was developed by the World Health Organization (WHO). The other questionnaire was developed for use by school health services and was based mainly on the American Thoracic Society (ATS) questionnaire for respiratory symptoms in childhood. It was called the Child Health Care (CHC) Questionnaire. Half of the parents received a questionnaire in which the WHO questions came first on both occasions, the other half a questionnaire in which the CHC questionnaire came first on both occasions. The reproducibility of the answers was assessed by calculating Cohen's Kappa, a chance-corrected measure of association. Questions about "wheeze", "asthma", "bronchitis", "cough and phlegm", and "pneumonia" were found to give good to excellent reproducibility, with Kappa values ranging from 0.60-0.96. Questions about "phlegm", "cough", "chest congestion" and "runny/congested nose" were less satisfactory in this respect, with Kappa values generally well below 0.60. The reproducibility of the answers did not depend on the order in which the questionnaires were administered, on the gender or age of the child, or on the smoking habits or educational level of the parents.