Comparing questionnaires for the assessment of acute mountain sickness

Exposure to high altitude in nonacclimatized subjects may lead to acute mountain sickness (AMS). AMS is a syndrome characterized by headache accompanied by one or more other symptoms, such as light-headedness, dizziness, loss of appetite, nausea, vomiting, fatigue, lassitude, and trouble sleeping. Assessing the presence and degree of AMS can be done using self-administered questionnaires like the Lake Louise Questionnaire (LLQ) and the Environmental Symptoms Questionnaire-III (ESQ-III). We compared LLQ and ESQ-III in 266 trekkers of different nationalities trekking over a 5400-m-high pass to assess if the two questionnaires identify the same population as suffering from AMS and to see whether using English questionnaires poses problems for nonnative English-speaking persons. The use of English questionnaires by nonnative English speakers influenced the outcome for some nationalities. For criterion scores yielding similar prevalence of AMS, ESQ-III labeled 20% of cases differently (AMS or no AMS) when compared to LLQ. Correlations between similar individual questions of ESQ-III and LLQ were variable, and there was considerable scatter between ESQ-III and LLQ scores. In conclusion, English questionnaires may pose problems in some international settings, and ESQ-III and LLQ may identify different populations as suffering from AMS.