Introduction to Medicine II
Class 6
Regent Teacher: Altamiro Pereira
Supervisor Teachers: Cristina Santos and Gustavo Bacelar
•
•
•
•
•
Introduction
Methods
Results and Discussion
Conclusion
References
2
The questionnaire design influences the
quality of questionnaire results, which
are also related to the choice of the
scale used in the questionnaire1.
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
1Pires,
M.D., G. Oliveira, and M. Behlau, Voice Activity and Participation Profile - VAPP administered in
two different scales of response. J Soc Bras Fonoaudiol, 2011. 23(3): p. 297-300.
3
Visual Numeric Scale (VNS)2
Discordo
totalmente
Concordo
totalmente
1
2
3
4
5
6
7
8
9
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
10
Visual Analogue Scale (VAS) 3
Discordo
totalmente
Concordo
totalmente
Numerical Rating Scale (NRS)
2 Hartman,
3
J.M., et al., Tutorials in clinical research: part IV: recognizing and controlling bias. Laryngoscope, 2002. 112(1): p. 23-31.
Choi, B.C. and A.W. Pak, A catalog of biases in questionnaires. Prev Chronic Dis, 2005. 2(1): p. A13.
4
Finding out:
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
• REPRODUCIBILITY of the scales
• AGREEMENT of the scales
5
• Target Population
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
o Students of Integrated Master’s
Degree in Medicine of FMUP, 1st
year and 1st time, with classes of
Introduction to Medicine II
6
• Target Population
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
Classes 6 and 7
7
• Longitudinal study
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
• Confidential questionnaires
8
Questionnaire A
1 (NRS)
2 (VAS)
3 (VNS)
4 (NRS)
5 (VNS)
6 (VAS)
Questionnaire B
REPRODUCIBILITY
AGREEMENT
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
1 (NRS)
2 (VAS)
3 (VNS)
4 (VAS)
5 (NRS)
6 (VNS)
9
TARGET
POPULATION
START
Yes
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
BLOCK
5
No
BLOCK
1
No
Yes
QUESTIONNAIRE A
QUESTIONNAIRE B
30 DAYS
30 DAYS
QUESTIONNAIRE B
QUESTIONNAIRE A
SPSS ANALYSIS
END
10
In order to assess reproducibility and
agreement we used:
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
• Bland and Altman plots
• Information Based Measure of
Disagreement (IBMD) with respective
95% confidence intervals
11
Programed sample
n=223
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
211 people answered at least one questionnaire
Analysed sample n=133 (60%)
(answered to both questionnaires)
12
Distribution of the gender of people who answered to both questionnaires
n=133
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
13
Quest. A
Question
median
1 – Uso com frequência
a internet para fazer
downloads
2 – Jogo
frequentemente on-line
3 - No meu estudo
recorro frequentemente
à internet
Quest. B
IQ range
median
IQ range
8
4
8
3,5
0,5
1,9
0,2
1,2
6,8
2,1
6,2
2,7
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
14
Median
IQ range
NRS
8
3,7
VAS
7,1
4,4
NRS
6
3,5
VNS
6
4
VAS
9,2
2,1
VNS
9
2
Question
4 - Comunico com
amigos/familiares
frequentemente pela Internet
5 - Acedo frequentemente a
informação diária na Internet
6 - Acedo frequentemente a
motores de busca para pesquisa
de informação
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
15
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
16
Question 1
Question 2
Uso com frequência a internet para fazer downloads
Jogo frequentemente on-line
[ -3,57 ; 3,47 ]
[ -3,45 ; 3,87 ]
Numeric Rating Scale
Visual Analogue Scale
Discordo
totalmente
Concordo
totalmente
Question 3
No meu estudo recorro frequentemente à internet
[ -3,75 ; 3,79 ]
Visual Numeric Scale
Discordo
totalmente
Concordo
totalmente
1
2
3
4
5
6
7
8
9
10
17
Information based measure of disagreement (IBMD)
IBMD=0 (no disgreement)
Scales
n
IBMD (95% CI)
NRS
129
0,2 [0,17 ; 0,24]
VAS
129
0,2 [0,17; 0,23]
VNS
133
0,2 [0,17 ; 0,23]
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
18
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
19
Question 4 – NRS vs VAS
Question 5 – VNS vs NRS
Comunico com amigos/familiares frequentemente pela Internet
Acedo frequentemente a informação diária na Internet
[ -5,21 ; 5,56 ]
[ -4,65 ; 4,51 ]
Question 6 – VAS vs VNS
Acedo frequentemente a motores de busca para pesquisa de informação
[ -3,03 ; 3,20 ]
Numeric Rating Scale
Visual Analogue Scale
Discordo
totalmente
Concordo
totalmente
Visual Numeric Scale
Discordo
totalmente
Concordo
totalmente
1
2
3
4
5
6
7
8
9
10
20
Information based measure of disagreement (IBMD)
IBMD=0 (no disgreement)
Scales
N
IBMD (95% CI)
NRS vs VAS
130
0,28 [0,24 ; 0,33]
VNS vs NRS
127
0,31 [0,27; 0,36]
VAS vs VNS
130
0,15 [0,13 ; 0,18]
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
21
• All the scales had an identical low
reproducibility
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
• Although the agreement between the scales in
study is very low, VAS and VNS are the most
accordable scales.
22
• Introduction
• Methods
• Bousquet, P.J., et al., Visual analog scales can assess the severity of rhinitis graded • Results and
according to ARIA guidelines. Allergy, 2007. 62(4): p. 367-372.
Discussion
• Choi, B.C. and A.W. Pak, A catalog of biases in questionnaires. Prev Chronic Dis, 2005. • Conclusion
2(1): p. A13.
• References
• Hartman, J.M., et al., Tutorials in clinical research: part IV: recognizing and controlling bias.
Laryngoscope, 2002. 112(1): p. 23-31.
• Hogikyan, N.D. and C.A. Rosen, A review of outcome measurements for voice disorders.
Otolaryngol Head Neck Surg, 2002. 126(5): p. 562-72.
• Pesudovs, K., et al., The development, assessment, and selection of questionnaires.
Optometry and Vision Science, 2007. 84(8): p. 663-674.
• Pires, M.D., G. Oliveira, and M. Behlau, Voice Activity and Participation Profile - VAPP
administered in two different scales of response. J Soc Bras Fonoaudiol, 2011. 23(3): p.
297-300.
• Price, D.D., et al., A comparison of pain measurement characteristics of mechanical visual
analogue and simple numerical rating scales. Pain, 1994. 56(2): p. 217-26.
• Rouve, S., et al., Numeric score and visual analog scale in assessing seasonal allergic rhinitis
severity. Rhinology, 2010. 48(3): p. 285-91.
• Schiavetti, N., et al., Direct magnitude estimation and interval scaling of stuttering severity.
J Speech Hear Res, 1983. 26(4): p. 568-73.
23
Professor Altamiro Pereira
• Introduction
• Methods
• Results and
Discussion
• Conclusion
• References
Teachers Cristina Santos and Gustavo Bacelar
Mr. Bruno Neves and Mrs. Marta Moreira
All the participants in the study
24
Introduction to Medicine II
Class 6
Regent Teacher: Altamiro Pereira
Supervisor Teachers: Cristina Santos and Gustavo
Bacelar