introduction to medicine ii class 6 regent teacher: altamiro pereira supervisor teachers: cristina...
TRANSCRIPT
Different Scales: Different Answers?
Introduction to Medicine IIClass 6
Regent Teacher: Altamiro Pereira
Supervisor Teachers: Cristina Santos and Gustavo Bacelar
Summary
• Introduction• Methods• Results and Discussion• Conclusion• References
2
Introduction • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
3
The questionnaire design influences the quality of
questionnaire results, which are also related to the choice of the
scale used in the questionnaire1.
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.
Introduction • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
4
Discordo totalmente
Concordo totalmente 1 2 3 4 5 6 7 8 9
10
Discordo totalmente
Concordo totalmente
Visual Numeric Scale (VNS)2
Visual Analogue Scale (VAS) 3
Numerical Rating Scale (NRS)2 Hartman, J.M., et al., Tutorials in clinical research: part IV: recognizing and controlling bias. Laryngoscope, 2002. 112(1): p. 23-31.
3 Choi, B.C. and A.W. Pak, A catalog of biases in questionnaires. Prev Chronic Dis, 2005. 2(1): p. A13.
Introduction - Aim • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
5
Finding out:
• REPRODUCIBILITY of the
scales
• AGREEMENT of the scales
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
6
• Target Population
o Students of Integrated Master’s Degree in Medicine of FMUP, 1st year and 1st time, with classes of Introduction to Medicine II
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
7
• Target Population
EXCEPTION:
Classes 6 and 7
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
8
• Longitudinal study
• Confidential questionnaires
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
9
1 (NRS)2 (VAS)3 (VNS)
4 (NRS)5 (VNS)6 (VAS)
1 (NRS)2 (VAS)3 (VNS)
4 (VAS)5 (NRS)6 (VNS)
Questionnaire A
Questionnaire B
REPRODUCIBILITY
AGREEMENT
No
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
10END
STARTTARGET
POPULATION
BLOCK 5
BLOCK 1
QUESTIONNAIRE A
QUESTIONNAIRE B
30 DAYS
30 DAYS
QUESTIONNAIRE B
QUESTIONNAIRE A
No Yes
SPSS ANALYSIS
Yes
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
11
In order to assess reproducibility and agreement
we used:
• Bland and Altman plots
• Information Based Measure of Disagreement (IBMD) with respective 95% confidence intervals
Methods • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
12
Programed sample n=223
211 people answered at least one questionnaire
Analysed sample n=133 (60%)(answered to both questionnaires)
Results and Discussion • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
13
n=133
Distribution of the gender of people who answered to both questionnaires
Results and Discussion • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
14
Question Quest. A Quest. B
median IQ range median IQ range
1 – Uso com frequência a internet para fazer downloads
8 4 8 3,5
2 – Jogo frequentemente on-line
0,5 1,9 0,2 1,2
3 - No meu estudo recorro frequentemente à internet
6,8 2,1 6,2 2,7
Results and Discussion • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
15
Question Median IQ range
4 - Comunico com amigos/familiares frequentemente pela Internet
NRS 8 3,7
VAS 7,1 4,4
5 - Acedo frequentemente a informação diária na Internet
NRS 6 3,5
VNS 6 4
6 - Acedo frequentemente a motores de busca para pesquisa de informação
VAS 9,2 2,1
VNS 9 2
1 – Assessing Reproducibility
16
Results and Discussion • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
17
Question 1Uso com frequência a internet para fazer
downloads
Numeric Rating Scale
Question 2Jogo frequentemente on-line
Question 3No meu estudo recorro frequentemente à internet
Visual Numeric ScaleDiscord
o totalmente
Concordo totalmente
1 2 3 4 5 6 7 8 9 10
Visual Analogue ScaleDiscordo
totalmente
Concordo totalmente
[ -3,45 ; 3,87 ] [ -3,57 ; 3,47 ]
[ -3,75 ; 3,79 ]
Results and Discussion
18
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]
Information based measure of disagreement (IBMD)IBMD=0 (no disgreement)
• Introduction
• Methods• Results
and Discussion
• Conclusion
• References
2 – Assessing Agreement
19
Results and Discussion • Introduction• Methods• Results and
Discussion• Conclusion• References
20
Question 4 – NRS vs VASComunico com amigos/familiares frequentemente
pela Internet
Question 5 – VNS vs NRSAcedo frequentemente a informação diária
na Internet
Question 6 – VAS vs VNSAcedo frequentemente a motores de busca para pesquisa de informação
[ -5,21 ; 5,56 ] [ -4,65 ; 4,51 ]
[ -3,03 ; 3,20 ] Numeric Rating Scale
Visual Numeric ScaleDiscord
o totalmente
Concordo totalmente
1 2 3 4 5 6 7 8 9 10
Visual Analogue ScaleDiscordo
totalmente
Concordo totalmente
Results and Discussion
21
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]
Information based measure of disagreement (IBMD)IBMD=0 (no disgreement)
• Introduction• Methods• Results and
Discussion• Conclusion• References
Conclusion • Introduction• Methods• Results and
Discussion• Conclusion• References
22
• All the scales had an identical low reproducibility
• Although the agreement between the scales in study is very low, VAS and VNS are the most accordable scales.
References • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
23
• Bousquet, P.J., et al., Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy, 2007. 62(4): p. 367-372.
• Choi, B.C. and A.W. Pak, A catalog of biases in questionnaires. Prev Chronic Dis, 2005. 2(1): p. A13.
• 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.
Acknowledgements • Introduction
• Methods• Results
and Discussion
• Conclusion
• References
24
Professor Altamiro Pereira
Teachers Cristina Santos and Gustavo Bacelar
Mr. Bruno Neves and Mrs. Marta Moreira
All the participants in the study
Different Scales: Different Answers?
Introduction to Medicine IIClass 6
Regent Teacher: Altamiro Pereira
Supervisor Teachers: Cristina Santos and Gustavo Bacelar