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Repeatability And Validity Of IUATLD Respiratory Questionnaire Responses As A Measure Of Asthma In An Ethiopian Population
Abstract
EAMJ Dec. Repeatability.indd Objective: To assess the repeatability and validity of the IUATLD respiratory symptoms questionnaire in relation to exercise-induced bronchoconstriction or bronchodilator responses in a community in southern Ethiopia.
Design: A case-control study.
Setting: Rural and small town setting in southern Ethiopia, April to May 2006.
Subjects: Two hundred and forty seven adults and children who previously reported wheeze in the past year, and 174 who did not.
Interventions: Administered IUATLD bronchial symptoms questionnaire; standardised free-running exercise test or (for those with airflow obstruction) assessment of bronchodilator response to inhaled salbutamol.
Results: Kappa values for four-week repeatability for the wheeze and asthma questions were 0.61 (95% CI 0.52 to 0.70) and 0.75 (0.63 to 0.87), respectively. Of the 58 people who reported wheeze in 2003 and in April 2006, only five had a positive exercise test or bronchodilator challenge (Positive Predictive Value (PPV) 0.09, 95% CI 0.01 to 0.22). Of the 12 who reported asthma in 2003 and April 2006, three had a positive result to either to exercise test or bronchodilator challenge test (PPV 0.25, 95% CI 0.05 to 0.50).
Conclusion: Our findings suggest that self-reported wheeze and asthma have good short-term repeatability, but do not closely reflect exercise-induced bronchospasm or bronchodilator responsiveness. The validity of questionnaire methods of studying asthma epidemiology in developing countries needs further investigation.
Design: A case-control study.
Setting: Rural and small town setting in southern Ethiopia, April to May 2006.
Subjects: Two hundred and forty seven adults and children who previously reported wheeze in the past year, and 174 who did not.
Interventions: Administered IUATLD bronchial symptoms questionnaire; standardised free-running exercise test or (for those with airflow obstruction) assessment of bronchodilator response to inhaled salbutamol.
Results: Kappa values for four-week repeatability for the wheeze and asthma questions were 0.61 (95% CI 0.52 to 0.70) and 0.75 (0.63 to 0.87), respectively. Of the 58 people who reported wheeze in 2003 and in April 2006, only five had a positive exercise test or bronchodilator challenge (Positive Predictive Value (PPV) 0.09, 95% CI 0.01 to 0.22). Of the 12 who reported asthma in 2003 and April 2006, three had a positive result to either to exercise test or bronchodilator challenge test (PPV 0.25, 95% CI 0.05 to 0.50).
Conclusion: Our findings suggest that self-reported wheeze and asthma have good short-term repeatability, but do not closely reflect exercise-induced bronchospasm or bronchodilator responsiveness. The validity of questionnaire methods of studying asthma epidemiology in developing countries needs further investigation.
