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Agreement between written and video questions for comparing asthma symptoms in ISAAC

¹ Wellington Asthma Research Group, Dept of Medicine, School of Medicine, Wellington, New Zealand. ² Dept of Pediatric Respiratory Medicine, Faculty of Medical Sciences, Hospital Centro de Referencia de Salud El Pino, University of Santiago de Chile, Santiago, Chile. ³ Dept of Community Health, and ⁴ Dept of Paediatrics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand

CORRESPONDENCE: J. Crane, Dept of Medicine, School of Medicine, PO Box 7343, Wellington, New Zealand. Fax: 64 43895427. E-mail: crane@wnmeds.ac.nz

Keywords: asthma, International Study of Asthma and Allergies in Childhood, prevalence, video questionnaire, wheezing, written questionnaire

Received: May 18, 2002
Accepted November 14, 2002

Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC) has reported the prevalence of asthma, rhinitis and eczema symptoms in children. In 99 centres from 40 countries, a total of just under 317,000 13–14-yr-old children also completed a video questionnaire, showing the symptoms and signs of asthma. This first video sequence has been compared to the ISAAC written question asking about current wheezing to explore variations in agreement and the contribution of each questionnaire to wheezing prevalence between centres, by region and language groups.

In general, responses to the video questionnaire gave a lower prevalence than the written questionnaire and responses were closely correlated. The overall proportion of agreement was high, mean 0.89, but unbalanced, with good negative agreement but poor positive agreement. Chance corrected agreement using Cohen's kappa coefficient, was generally low, with only 20 centres with kappa >0.4. The contribution of each questionnaire to wheezing prevalence also varied between centres and suggests that written questions about wheezing are variably understood and interpreted by 13–14 yr olds.

International comparisons of wheezing and its audiovisual presentation suggest that adolescents interpret a written question about wheezing differently from its audiovisual presentation and that this interpretation shows variation between centres. This relationship and the interpretation of both written and audiovisual presentation of symptoms requires further study in order to better predict asthma.

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