Journal of Preventive Medicine and Public Health

Original Articles

Reliability of a Newly Developed Tool to Assess and Classify Work-related Stress (TAWS-16) for Indian Workforce: Gautham Melur Sukumar, Runalika Roy, Mariamma Philip, Gururaj Gopalkrishna; J Prev Med Public Health. 2023;56(5):407-412. Published online August 19, 2023; DOI: https://doi.org/10.3961/jpmph.23.219

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Abstract Summary PDF: Objectives
Work stress is associated with non-communicable diseases, increased healthcare costs, and decreased work productivity among employees in the information technology sector. There is a need for regular work-stress screening among employees using valid and reliable tools. The Tool to Assess and Classify Work Stress (TAWS-16) was developed to overcome limitations in existing stress assessment tools in India. This study aimed to test the reliability of TAWS-16 in a sample of managerial-supervisory employees.
Methods
This observational reliability study included data from 62 employees. Test-retest and inter-method reliability were investigated using a TAWS-16 web application and interview by telephone, respectively. Kappa values and intra-class correlation coefficients were calculated. Internal consistency was assessed through Cronbach’s alpha.
Results
For both test-retest and inter-method reliability, the agreement for both work-related factors and symptoms suggestive of work stress exceeded 80%, and all kappa values were 0.40 or higher. Cronbach’s alpha for test-retest and inter-method reliability was 0.983 and 0.941, respectively.
Conclusions
TAWS-16 demonstrated acceptable reliability. It measured stressors, coping abilities, and psychosomatic symptoms associated with work stress. We recommend using TAWS-16 to holistically identify work stress among employees during periodical health check-ups in India.; Summary

Key Message
The study assessed test-retest and inter-method reliability of Tool to Assess Work Stress (TAWS – 16) developed by Centre for Public Health, National Institute of Mental Health and Neurosciences (NIMHANS) on 62 employees in Bengaluru, India. Kappa statistics, Intra-class correlation coefficient (ICC) and Cronbach’s alpha were calculated. TAWS – 16 demonstrated acceptable reliability, good internal consistency and can be used to identify work stress among employees during periodical health check-ups in Indian setting.

Teleworking Survey in Saudi Arabia: Reliability and Validity of Arabic Version of the Questionnaire: Heba Yaagoub AlNujaidi, Mehwish Hussain, Sama’a H. AlMubarak, Asma Saud AlFayez, Demah Mansour AlSalman, Atheer Khalid AlSaif, Mona M. Al-Juwair; J Prev Med Public Health. 2022;55(6):578-585. Published online November 18, 2022; DOI: https://doi.org/10.3961/jpmph.22.242

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Abstract PDF Supplementary Material: Objectives
This study aimed to adapt the survey questionnaire designed by Moens et al. (2021) and determine the validity and reliability of the Arabic version of the survey in a sample of the Saudi population experiencing teleworking.
Methods
The questionnaire includes 2 sections. The first consists of 13 items measuring the impact of extended telework during the coronavirus disease 2019 (COVID-19) crisis. The second section includes 6 items measuring the impact of the COVID-19 crisis on self-view of telework and digital meetings. The survey instrument was translated based on the guidelines for the cultural adaptation of self-administrated measures.
Results
The reliability of the questionnaire responses was measured by Cronbach’s alpha. The construct validity was checked through exploratory factor analysis followed by confirmatory factor analysis (CFA) to further assess the factor structure. CFA revealed that the model had excellent fit (root mean square error of approximation, 0.00; comparative fit index, 1.0; Tucker-Lewis index, 1; standardized root mean squared residual, 0.0).
Conclusions
The Arabic version of the teleworking questionnaire had high reliability and good validity in assessing experiences and perceptions toward teleworking. While the validated survey examined perceptions and experiences during COVID-19, its use can be extended to capture experiences and perceptions during different crises.; Summary

Brief Report

Reliability and Validity of a Life Course Passive Smoke Exposure Questionnaire in an Australian Cohort From Childhood to Adulthood: Chigozie Ezegbe, Costan G. Magnussen, Amanda Louise Neil, Marie-Jeanne Buscot, Terence Dwyer, Alison Venn, Seana Gall; J Prev Med Public Health. 2021;54(2):153-159. Published online March 10, 2021; DOI: https://doi.org/10.3961/jpmph.20.559

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Abstract PDF Supplementary Material

Objectives
Life course exposure to passive smoke may predict health, but there are few validated measures. We tested the reliability and validity of a retrospective life course passive smoking questionnaire.
Methods
Participants from the third follow-up of the Childhood Determinants of Adult Health study (2014-2019, ages 36-49 years) retrospectively reported mother/father/other household member smoking when living at home during childhood, including duration (years) and smoking location (never/sometimes/always inside house). The severity of exposure index (SEI; sum of mother/father/other years smoked multiplied by smoking location), cumulative years of exposure (CYE; sum of mother/father/other years), and total household smokers (THS) were derived. The reliability of retrospective passive smoking reports was examined with intraclass correlation coefficients (ICCs) using household smoking reported 34 years earlier in 1985 by participants when aged 7-15 years. Construct validity was examined by correlating retrospective passive smoking with participants’ smoking in adulthood and lung function in childhood and adulthood.
Results
Among 2082 participants (mean±standard deviation [SD], 45.0±2.5 years; 55.2% females), THS ranged from 0 to 5 (mean± SD, 0.9±1.0), CYE ranged from 0 to 106 (mean±SD, 10.5±13.9), and SEI ranged from 0 to 318 (mean±SD, 24.4±36.0). Retrospective measures showed moderate agreement with total household smokers reported in childhood (ICC, 0.58 to 0.62). The retrospective measures were weakly but significantly (p<0.05) correlated with participants’ smoking (r=0.13 to 0.15) and lung function (r= -0.05 to -0.06).
Conclusions
The retrospective passive smoking questionnaire showed reasonable reliability and validity. This measure may be useful for epidemiological studies.

Summary

Citations

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Childhood secondhand smoke exposure and respiratory disease mortality among never-smokers: the Japan collaborative cohort study for evaluation of cancer risk
Haruna Kawachi, Masayuki Teramoto, Isao Muraki, Kokoro Shirai, Kazumasa Yamagishi, Akiko Tamakoshi, Hiroyasu Iso
Journal of Public Health.2023; 45(3): 604. CrossRef

Original Articles

Verification of the Reliability and Validity of the Short Form 36 Scale in Indonesian Middle-aged and Older Adults: Novita Intan Arovah, Kristiann C. Heesch; J Prev Med Public Health. 2020;53(3):180-188. Published online April 14, 2020; DOI: https://doi.org/10.3961/jpmph.19.324

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Abstract PDF Supplementary Material

Objectives
The Short Form 36 (SF-36) questionnaire is increasingly being used to measure health-related quality of life (HRQoL) in Indonesia. However, evidence that it is valid for use in Indonesian adults is lacking. This study assessed the validity and reliability of the SF-36 in Indonesian middle-aged and older adults.
Methods
Adults aged 46-81 years (n=206) in Yogyakarta, Indonesia completed the SF-36, another measure of HRQoL (the EuroQoL visual analogue scale [EQ-VAS]), and measures assessing their demographic characteristics. Fifty-four percent (n=121) completed the SF-36 measure again 1 week later. Confirmatory factor analysis was conducted to confirm the factor structure of the SF-36. Internal consistency reliability was estimated using Cronbach’s alpha, and test-retest reliability was assessed using intraclass correlations. Convergent and discriminant validity were assessed by computing correlations among SF-36 subscales, between subscales and the 2 component scores, and between component scores and EQ-VAS scores.
Results
Most scaling assumptions were met. The hypothetical factor structure fit the data poorly (root mean square error of approximation [RMSEA]=0.108) and modification was required for a good fit (RMSEA=0.060). Scores on all subscales demonstrated acceptable internal consistency (α>0.70) and test-retest reliability (r>0.70). Divergent validity was supported by weak to moderate interscale correlations (r=0.19 to 0.64). As expected, the 2 summary scores were moderately to strongly correlated with the EQ-VAS (r>0.60).
Conclusions
The findings adequately support the use of SF-36 in Indonesian middle-aged and older adults, although the optimal algorithm for computing component scores in Indonesia warrants further investigation.

Summary

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Sayuri Yamashita, Yasuhiro Katsumata, Naoko Konda, Rangi Kandane-Rathnayake, Eric F Morand, Masayoshi Harigai
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Health measurement instruments and their applicability to military veterans: a systematic review
Jane Jomy, P Jani, F Sheikh, R Charide, J Mah, R J Couban, B Kligler, A J Darzi, B K White, T Hoppe, J W Busse, D Zeraatkar
BMJ Military Health.2023; : e002219. CrossRef
ПРИМЕНЕНИЕ ПАРАМЕТРИЧЕСКИХ И ОПРОСНИКОВЫХ МЕТОДОВ ИССЛЕДОВАНИЯ ДИСКОГЕНННОГО БОЛЕВОГО СИНДРОМА У ВЗРОСЛЫХ
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Assessing Reliability of Medical Record Reviews for the Detection of Hospital Adverse Events: Minsu Ock, Sang-il Lee, Min-Woo Jo, Jin Yong Lee, Seon-Ha Kim; J Prev Med Public Health. 2015;48(5):239-248. Published online September 11, 2015; DOI: https://doi.org/10.3961/jpmph.14.049

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Abstract PDF Supplementary Material

Objectives
The purpose of this study was to assess the inter-rater reliability and intra-rater reliability of medical record review for the detection of hospital adverse events.
Methods
We conducted two stages retrospective medical records review of a random sample of 96 patients from one acute-care general hospital. The first stage was an explicit patient record review by two nurses to detect the presence of 41 screening criteria (SC). The second stage was an implicit structured review by two physicians to identify the occurrence of adverse events from the positive cases on the SC. The inter-rater reliability of two nurses and that of two physicians were assessed. The intra-rater reliability was also evaluated by using test-retest method at approximately two weeks later.
Results
In 84.2% of the patient medical records, the nurses agreed as to the necessity for the second stage review (kappa, 0.68; 95% confidence interval [CI], 0.54 to 0.83). In 93.0% of the patient medical records screened by nurses, the physicians agreed about the absence or presence of adverse events (kappa, 0.71; 95% CI, 0.44 to 0.97). When assessing intra-rater reliability, the kappa indices of two nurses were 0.54 (95% CI, 0.31 to 0.77) and 0.67 (95% CI, 0.47 to 0.87), whereas those of two physicians were 0.87 (95% CI, 0.62 to 1.00) and 0.37 (95% CI, -0.16 to 0.89).
Conclusions
In this study, the medical record review for detecting adverse events showed intermediate to good level of inter-rater and intra-rater reliability. Well organized training program for reviewers and clearly defining SC are required to get more reliable results in the hospital adverse event study.

Summary

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The Korea National Patient Safety Incidents Inquiry Survey: Characteristics of Adverse Events Identified Through Medical Records Review in Regional Public Hospitals
Min Ji Kim, Hee Jung Seo, Hong Mo Koo, Minsu Ock, Jee-In Hwang, Sang-Il Lee
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Minsu Ock, Min-Woo Jo, Eun Young Choi, Sang-Il Lee
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English Abstract

Reliability of Self-Reported Information by Farmers on Pesticide Use.: Yo Han Lee, Eun Shil Cha, Eun Kyeong Moon, Kyoung Ae Kong, Sang Baek Koh, Yun Keun Lee, Won Jin Lee; J Prev Med Public Health. 2010;43(6):535-542.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.535

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OBJECTIVES
Exposure assessment is a major challenge faced by studies that evaluate the association between pesticide exposure and adverse health outcomes. The objective of this study was to investigate the reliability of information that farmers self-report regarding their pesticide use. METHODS: Twenty five items based upon existing questionnaires were designed to focus on pesticide exposure. In 2009 a self-administrated survey was conducted on two occasions four weeks apart among 205 farmers residing in Gyeonggi and Gangwon provinces. For a reliability measure, we calculated the percentage agreement, the kappa statistics and the intraclass correlation coefficient (ICC) between the two reports according to the characteristics of the subjects. RESULTS: Agreement for ever-never use of any pesticide was 96.4% (kappa 0.61). For both 'years used' and 'age at the first use' of overall pesticides, high agreement was obtained (ICC: 0.88 and, 0.78, respectively), whereas those of 'days used' and 'hours used' were relatively low (ICC: 0.42 and, 0.66, respectively). The kappa value for the use of personal protective equipment ranged from 0.46 to 0.59, and hygiene activities came out at 0.19 to 0.37. The agreement for individual pesticide use ranged widely and there was relatively low agreement due to the low response rates. The reliability scores did not significantly vary according to gender, age, the education level, the types of crop or the years of farming. CONCLUSIONS: Our results support that carefully designed, self-reported information on ever-never pesticide use among farmers is reliable. However, the reliability of data on individual pesticide exposure may be unstable due to low response rates and needs to be refined.

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William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Iris van den Brenk, Hans Kromhout, Ioannis Basinas, Kate Jones, Andrew Povey, Martie van Tongeren, Anne-Helen Harding, Karen S. Galea, Samuel Fuhrimann
International Journal of Hygiene and Environmental Health.2022; 240: 113911. CrossRef
Recall of exposure in UK farmers and pesticide applicators: trends with follow-up time
William Mueller, Kate Jones, Hani Mohamed, Neil Bennett, Anne-Helen Harding, Gillian Frost, Andrew Povey, Ioannis Basinas, Hans Kromhout, Martie van Tongeren, Samuel Fuhrimann, Karen S Galea
Annals of Work Exposures and Health.2022; 66(6): 754. CrossRef
Increased risk of atherosclerosis associated with pesticide exposure in rural areas in Korea
Sungjin Park, Jung Ran Choi, Sung-Kyung Kim, Solam Lee, Kyungsuk Lee, Jang-Young Kim, Sung-Soo Oh, Sang-Baek Koh, Paula Boaventura
PLOS ONE.2020; 15(5): e0232531. CrossRef
Exposure to pesticides and the prevalence of diabetes in a rural population in Korea
Sungjin Park, Sung-Kyung Kim, Jae-Yeop Kim, Kyungsuk Lee, Jung Ran Choi, Sei-Jin Chang, Choon Hee Chung, Kyu-Sang Park, Sung-Soo Oh, Sang-Baek Koh
NeuroToxicology.2019; 70: 12. CrossRef
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Moon Jung Kim, Eun Shil Cha, Yousun Ko, Byung Chul Chun, Won Jin Lee
American Journal of Industrial Medicine.2017; 60(4): 377. CrossRef
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Jiyeon Lim, Hyung-Suk Yoon, Mansuk Park, Young Seoub Hong, Jong-Koo Lee, Se-Eun Oh, Daehee Kang, Kyoung-Mu Lee
Korean Journal of Environmental Health Sciences.2016; 42(2): 71. CrossRef
Symptom Prevalence and Work-related Risk Factors of Acute Pesticide Poisoning among Korean Farmers in Gyeong-gi Province
Hyang Seok Lee, Ji Hoon Lee, Soo Yong Roh, Ho Gil Kim, Kyung Jun Lee, Sun Ju Nam-gung, Soon Chan Kwon, Soo Jin Lee
Journal of agricultural medicine and community health.2015; 40(4): 228. CrossRef
A Pilot Study for Pesticide Poisoning Symptoms and Information on Pesticide Use among Farmers
Hyun-Joong Kim, Eun-Shil Cha, Eun-Kyeong Moon, You-Sun Ko, Jae-Young Kim, Mi-Hye Jeong, Won-Jin Lee
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Pesticide Exposure and Health
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Korean Journal of Environmental Health Sciences.2011; 37(2): 81. CrossRef

Original Article

Reliability of Covariates in Baseline Survey of a Cohort Study: Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea.: Sanghyuk Bae, Bo Young Park, Zhong Min Li, Yoon Ok Ahn; J Prev Med Public Health. 2010;43(2):159-165.; DOI: https://doi.org/10.3961/jpmph.2010.43.2.159

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OBJECTIVES
We evaluated the reliability of the possible covariates of the baseline survey data collected for the Epidemiological Investigation on Cancer Risk Among Residents Who Reside Near the Nuclear Power Plants in Korea. METHODS: Follow-up surveys were conducted for 477 participants of the cohort at less than 1 year after the initial survey. The mean interval between the initial and follow-up surveys was 282.5 days. Possible covariates were identified by analyzing the correlations with the exposure variable and associations with the outcome variables for all the variables. Logistic regression analysis with stepwise selection was further conducted among the possible covariates to select variables that have covariance with other variables. We considered that these variables can be representing other variables. Seven variables for the males and 3 variables for the females, which had covariance with other possible covariates, were selected as representative variables. The Kappa index of each variable was calculated. RESULTS: For the males, the Kappa indexes were as follow; family history of cancer was 0.64, family history of liver diseases in parents and siblings was 0.56, family history of hypertension in parents and siblings was 0.51, family history of liver diseases was 0.50, family history of hypertension was 0.44, a history of chronic liver diseases was 0.53 and history of pulmonary tuberculosis was 0.36. For females, the Kappa indexes were as follow; family history of cancer was 0.58, family history of hypertension in parents and siblings was 0.56 and family history of hypertension was 0.47. CONCLUSIONS: Most of the possible covariates showed good to moderate agreement.

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Cancer Risk in Adult Residents near Nuclear Power Plants in Korea - A Cohort Study of 1992-2010
Yoon-Ok Ahn, Zhong Min Li
Journal of Korean Medical Science.2012; 27(9): 999. CrossRef

Research Support, Non-U.S. Gov't

The Validity and Reliability of a Screening Questionnaire for Parkinson's Disease in a Community.: Jong Hun Kim, Hae Kwan Cheong, Chong Sik Lee, Sung Eun Yi, Kun Woo Park; J Prev Med Public Health. 2010;43(1):9-17.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.9

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OBJECTIVES
Parkinson's disease is one of the most common neurodegenerative diseases in the elderly population. In order to estimate the prevalence of Parkinson's disease in the community, the application of a good screening tool is essential. We evaluated the validity and reliability of a Parkinson's disease screening questionnaire and propose an alternative measure to improve its validity for use in community surveys. METHODS: We designed the study in a three-phase approach consisting of a screening questionnaire, neurologic examination, and confirmatory examination. A repeated survey was administered to patients with disease detected in the community and on 150 subjects. We examined internal consistency using Cronbach's alpha test, test-retest reliability using the kappa statistic, and validity using sensitivity, specificity, and ROC curves. Unadjusted odds ratios were utilized for the estimation of weights for each questionnaire item. RESULTS: The Cronbach's alpha of the questionnaire was 0.708. The kappa statistic for test-retest reliability was good to generally fair in most of the items. When newly proposed weighting scores were used, the optimum cut-off value was 7/8. When cut-off value was 5/6 for surveying prevalence in a community, the sensitivity was 0.98, and the specificity was 0.61, with simultaneous improvement in reliability. CONCLUSIONS: We recommend 5/6 as the ideal cut-off value for the survey of PD prevalence in community. This questionnaire designed for the Korean community could help future epidemiologic studies of PD.

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Chol Shin, Regina E. Y. Kim, Robert J. Thomas, Chang-Ho Yun, Seung Ku Lee, Robert D. Abbott
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Jose Danilo B. Diestro, Mark Angelo C. Ang, Mark Willy L. Mondia, Paul Matthew D. Pasco
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Alain Lekoubou, Justin B Echouffo-Tcheugui, Andre P Kengne
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Ying LIU, Jin-hu FAN, Wen CHEN, Zhi-yu NIE, You-lin QIAO, Lin ZHANG
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Validation Studies

Reliability of a Questionnaire for Women's Reproductive History.: Kwang Pil Ko, Sue Kyung Park, Yeonju Kim, Jisuk Bae, Jae kwan Jun, Jin Gwack, Keun Young Yoo; J Prev Med Public Health. 2008;41(3):181-185.; DOI: https://doi.org/10.3961/jpmph.2008.41.3.181

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OBJECTIVES
This study was performed to evaluate the reproducibility of a questionnaire concerned with reproductive history and to ascertain which characteristics of the subjects (age, the visit-revisit intervals, education and chronic disease) are associated with good reliability in the Korean Multi-Center Cancer Cohort (KMCC) study. MATERIALS AND METHODS: A total of 19,688 participants were enrolled between 1993 and 2004. Among them, we selected 386 participants who were aged 40 or more and who re-visited within 8 years after the first visit. Reliability was measured by the percent agreement according to error range for the continuous variables and the percent agreement and kappa statistics for the categorical variables. RESULTS: The pregnancy histories were reliable (kappa=0.67) and the reasons for being menopausal among the postmenopausal women were also reliable (kappa=0.92). The percent agreement of the breast-feeding history was high (96.1%), although the kappa statistic was low. For the continuous variables, when the error range of one variable was considered to be reliable, the percent agreement of the age at menarche and the age at the first full term pregnancy was good (69.4% and 83.6%), whereas that of the age at menopause was low (51.5%). The factors associated with high reliability were a younger age, the presence of chronic disease and a short visit-revisit time interval. CONCLUSIONS: The agreements for parity, the reasons for menopause, and the breastfeeding history in the reproductive history questionnaire used in the KMCC were relatively good. The questionnaire for the menarche age and the menopausal age might have lower reliability due to the difference between Korean age and American age. To obtain reliable information, more attention should be given to the items in questionnaire-based surveys, and especially for surveying old-aged women.

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Persistent effects of women’s parity and breastfeeding patterns on their body mass index: results from the Million Women Study
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International Journal of Obesity.2013; 37(5): 712. CrossRef
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Comparative Study

Disability Weights for Diseases in Korea.: Jung Kyu Lee, Seok Jun Yoon, Young Kyung Do, Young Hoon Kwon, Chang Yup Kim, Kidong Park, Yong Ik Kim, Young Soo Shin; Korean J Prev Med. 2003;36(2):163-170.

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Abstract PDF: OBJECTIVES
This study aimed to develop an evaluation protocol of disability weights using person trade-off, and to test the reliability of the developed protocol in a Korean context. METHODS: To develop the valuation protocol, the Global Burden of Disease (GBD) and the Dutch studies were replicated and modified. Sixteen indicator conditions were selected from the Korean version of disease classification, which was based on that of the GBD Study, and the person trade-off method referred to the Dutch method. RESULTS: The disability weights were valued in a two step panel study. The first step was a carefully designed group process by three panels, using person trade-off to establish the disability weights for sixteen selected indicator conditions. The second step consisted of interpolation of the remaining diseases, on a disability scale, by the individual members of three panels. The members of three panels were all medical doctors, with sufficient knowledge of the consequences of a broad variety of diseases. The internal consistency of the Korean disability weights was satisfactory. Considerable agreement existed within each panel and among the panels. CONCLUSIONS: It was feasible to use a modified evaluation protocol from those used in GBD and Dutch studies. This would provide a rational basis for an international comparative study of disability weights.; Summary

Original Articles

The Development of Physical Functioning Scale for Community-Dwelling Older Persons.: Yun Hwan Lee, Kyung Jong Lee, Geun Shik Han, Soo Jin Yoon, Yeon Kyung Lee, Chan Ho Kim, Jeong Lim Kim; Korean J Prev Med. 2002;35(4):359-374.

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Abstract PDF: OBJECTIVES
To develop a physical functioning instrument for older adults living in the community. METHODS: A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. RESUJLTS: Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PF) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, survey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. CONCLUSIONS: The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.; Summary

Reliability and Validity of the Korean Version of ISAAC Questionnaire.: Seong Woo Choi, Yeong Su Ju, Dae Sung Kim, Jae Yong Kim, Ho Jang Kwon, Dae Hee Kang, Sang Il Lee, Soo Hun Cho; Korean J Prev Med. 1998;31(3):361-371.

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Abstract PDF: Recent increases of asthma and allergies in childhood made the need for a standardized approach to international and regional comparisons of their prevalence and severity. To address these issues, "International Study of Asthma and Allergies in Childhood (ISAAC)" is currently underway. In Korea, "Nationwide Study of Asthma and Allergies in Korean Children" began in 1995 according to ISAAC protocol. ISAAC written and video questionnaires were used in this survey, but their reliability and validity were not evaluated properly yet. In this study, our aim was to evaluate the reliability and validity of two kinds of questionnaires and their usefulness in international and regional comparisons. The test and retest of two questionnaires were completed by male(n=110) and female(n=111) middle school students with two and three weeks interval each. Kappa(or weighted kappa) were calculated from each questions and validity coefficients were estimated from those statistics. In Korean version of written questionnaire, the questions for allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and food allergy proved to have high kappa values(or weighted kappa values) and validity coefficients and they can be used in further studies without any correction. But some questions about asthma(especially nocturnal cough, wheezing in exercise, and severe asthma) and drug allergy need to be revised for better understanding to study subjects. Video questionnaire has the same degree of reliability and validity when compared to written questionnaire and this is the unexpected result. Accordingly, it also need to be revised to overcome the racial and cultural differences of the study subjects. In conclusion, the Korean version of written and video questionnaires may be considered to be useful methods in international and regional comparisons of asthma and allergic diseases in childhood after correction of some questions.; Summary

Reliability and validity study of a life style questionnaire for elderly people.: Byiung Joo Park, Dae Sung Kim, Hye Won Koo, Jong Myon Bae; Korean J Prev Med. 1998;31(1):49-58.

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Abstract PDF: The study was done to determine the reliability and validity of a life style questionnaire for the elderly. The questionnaires were sent to 16,524 elderly people who were beneficiaries of Korean Medical Insurance Corporation in Pusan. Among the completed 9,139 questionnaires, 200 were randomly sampled and retested. Finally, 110 duplicates were collected. Weighted kappa-value and Pearson correlation coefficients were estimated to measure the reliability. Validity coefficient was estimated by using reliability coefficient. In self-self responses, reliability coefficients of the most of items were over 0.6 except some physical activity related item. Relatively high reliability was observed in smoking, alcohol related items and anthropometric items. In self-proxy responses, most of the physical activity related items were found to be less reliable than self-self responses. Smoking and alcohol related items were consistently reliable. Male showed higher validity in food related item than female. On the other hand, some of the physical activity related items and smoking and alcohol related items were less valid in male than female. With regard to bias of proxy respondents, offsprings tended to underestimate the frequency of 'house cleaning' and 'kitchen work' and overestimate the height of them. In conclusion, the life style questionnaire was found to be reliable in the most of items. But, some items related with physical activity were found to be somewhat less reliable. Sexual difference on the validity was identified in some items. With regard to bias of proxy respondents, offsprings tended to have bias in part of items of housework and anthropometry.; Summary

Development of Questionnaire for Evaluating Health Effect Associated with Air Pollution.: Yeong Su Ju, Dae Sung Kim, Jong Won Kang, Joo Heon Seong, Dae Hee Kang, Soo Hun Cho, Do Myung Paek; Korean J Prev Med. 1997;30(4):852-869.

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Abstract PDF: This study was conducted to develope and evaluate the reliability and the validity of a questionnaire in order to determine the applicability as a screening tool for estimating environmental exposure and health effects related to air pollution. The questionnaire was developed with adopting some items of others such as ISAAC or ATS-DLD. And then we performed test-retest to 89 middle school students and their mothers at interval of three months. Cohen's Kappa values, weighted Kappa values, Spearman's correlation coefficients, and Pearson's correlation coefficients for each item were computed as reliability coefficients. The validity coefficients and validity coefficient bounds were also obtained by simply using these reliability coefficients. As results, Kappa ranged broadly from 0.10 to 0.61 of the items 'diet', 0.52~0.79 of the environmental tobacco smoke, 0.39~0.44 of the functional categories of surrounding environment, and 0.54~0.63 of the using transportation systems; these items were regarded as confounding factors. For items related to health outcomes, Kappa ranged from -0.02 to 0.37 in the respiratory system of past medical history, and from 0.11 to 0.55 in the current health status. But Kappa of the others were over 0.60. In conclusion, if some items can be corrected or modified, the questionnaire developed in this study can be used as a tool for evaluating environmental exposure and health effects associated with air pollution.; Summary

Reliability for Multiple Reviewers by using Loglinear Models.: Byung Joo Park, Sung Im Lee, Young Jo Lee, Dong Hyun Kim, Ho Jang Kwon, Jong Myon Bae, Myung Hee Shin, Mi Na Ha, Sang Whan Han; Korean J Prev Med. 1997;30(4):719-728.

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Abstract PDF: To guarantee the inter-reviewer reliability is very important in evaluating the quality of large number of clinical research papers by multiple reviewers. We cannot find reports on statistical methods for evaluating reliability for multiple raters in clinical research field. The purpose of this paper is to introduce the statistical methods focused on kappa statistic and five kinds of loglinear models for, which can be applied when evaluating the reliability of multiple raters. We have applied these methods to the result of a project, in which seven reviewers have evaluated the quality of 33 papers with regard to four aspects of paper contents including study hypothesis, study design, study population, study method, data analysis and interpretation. Among the five loglinear models including Symmetry model, Conditional symmetry model, Quasi-symmetry model, Independence model, and Quasi-independence model, Quasi-symmetry model shows the best model of fitting. And the level of reliability among seven reviewers revealed to be acceptable as meaningful.; Summary

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