Reporting to Improve Reproducibility and Facilitate Validity Assessment for Healthcare Database Studies V1.0

Purpose

Defining a study population and creating an analytic dataset from longitudinal healthcare databases involves many decisions. Our objective was to catalogue scientific decisions underpinning study execution that should be reported to facilitate replication and enable assessment of validity of studies conducted in large healthcare databases.

Validity of the Center for Epidemiological Studies Depression Scale among Brazilian elderly

OBJECTIVE: To obtain internal construct and criteria validity for the Center of Epidemiological Studies--Depression Scale in elderly people. METHODS: The instrument was applied to 903 elderly living in a city in southeastern Brazil, between 2002 and 2003. Results were compared with the Brazilian version of the CES-D applied to a sub-sample of 446 participants. Internal consistency of the two scales was assessed using Cronbach's alpha measured for the items in their total and for the items of each factor obtained for the assessed instrument. To assess the construct validity, the 20 items underwent exploratory factorial analysis to discover their variation pattern and the variance explained according to each factor. RESULTS: The scale presented satisfactory index for internal validity (alpha=0.860), sensibility (74.6%), specificity (73.6%), and for cutoff point >11. However, it presented a relatively high frequency of false positives compared to the GDS 33.8% vs. 15%. Exploratory factorial analysis of the instrument created factorial structure with three factors: negative affects, problems initiating behaviors, and positive affects. CONCLUSIONS: The instrument seemed to be psychometrically suitable when applied to older people. However, further cross-sectional and longitudinal studies, carried out in different contexts, may explain the effects of somatic and situational variables on the results of the instrument in older people.     

The Comparative Validity and Reproducibility of a Diet Quality Index for Adults: The Australian Recommended Food Score

Adult diet quality indices are shown to predict nutritional adequacy of dietary intake as well as all-cause morbidity and mortality. This study describes the reproducibility and validity of a food-based diet quality index, the Australian Recommended Food Score (ARFS). ARFS was developed to reflect alignment with the Australian Dietary Guidelines and is modelled on the US Recommended Food Score. Dietary intakes of 96 adult participants (31 male, 65 female) age 30 to 75 years were assessed in two rounds, five months apart. Diet was assessed using a 120-question semi-quantitative food frequency questionnaire (FFQ). The ARFS diet quality index was derived using a subset of 70 items from the full FFQ. Reproducibility of the ARFS between round one and round two was confirmed by the overall intraclass correlation coefficient of 0.87 (95% CI 0.83, 0.90), which compared favourably to that for the FFQ at 0.85 (95% CI 0.80, 0.89). ARFS was correlated with FFQ nutrient intakes, particularly fiber, vitamin A, beta-carotene and vitamin C (0.53, 95% CI 0.37–0.67), and with mineral intakes, particularly calcium, magnesium and potassium (0.32, 95% CI 0.23–0.40). ARFS is a suitable brief tool to evaluate diet quality in adults and reliably estimates a range of nutrient intakes.     

The Relative Validity and Reproducibility of Food Frequency Questionnaires in the China Kadoorie Biobank Study

Background: Short versions of qualitative and quantitative food frequency questionnaires (FFQs) are widely used to assess usual food intake. However, fewer studies evaluated their relative validity and reproducibility in the Chinese population. Methods: This study compared 12-day 24-h dietary recalls with qualitative and quantitative FFQs designed by the China Kadoorie Biobank (CKB) study to assess the relative validity. Two FFQs were administered in the second and third seasons and compared to evaluate the reproducibility. Statistical tests included Spearman correlation coefficients, weighted kappa, and cross-classification. Results: A total of 432 participants were eligible after stratifying by age, sex, and four regions. In the validation of qualitative FFQ, adjusted Spearman coefficients were between 0.23 and 0.59, and weighted kappa coefficients ranged from 0.61 to 0.88, except for fresh vegetables. The percentage of correct classification was highest in fresh vegetables and lowest in fresh fruit, but the percentages of extreme classification were below 3.0%. Corresponding Spearman and kappa coefficients for the reproducibility were 0.17–0.56 and 0.62–0.90. Furthermore, the correct classification constituted between 35.6 and 93.3% of all participants. Regarding the relative validity of the quantitative FFQ, Spearman coefficients ranged from 0.14 to 0.69 in addition to dried vegetables and carbonated soft drinks. For items with more than two-thirds of total participants consumed, weighted kappa coefficients were from 0.57 to 0.79; correct classification percentages were between 34.6% and 67.5%. Spearman and kappa coefficients for the reproducibility of the quantitative FFQ were 0.15–0.71 and 0.60–0.86, respectively; correct classification percentages varied from 47.8% to 71.6%. Conclusion: Most food items from the qualitative FFQ showed acceptable or even good relative validity and reproducibility in the CKB study. Likewise, major food items in the quantitative FFQ were valid and reproducible, but poor performances of dried vegetables and carbonated soft drinks indicated the need for modification and validation in future research.     

出入境人员152例异常心电图分析

[目的]了解菏泽口岸出入境人员心电图异常情况。[方法]对2002年6月～2003年7月1390名出入境人员心电图检查结果进行分析。[结果]检出心电图异常152例，检出率10．94％，其中主要异常心电图检出率4．96％，次要异常心电图检出率5．97％。4项主要相关因素中，吸烟及高血压的检出率最高，分别为4．10％及3．24％。[结论]加强出入境人员疾病监测，提高对异常心电图临床意义的认识，有针对性地开展健康咨询，对防治心血管疾病，降低意外事件发生率十分重要。     

Development,Relative Validity,and Reproducibility of a Short Food Frequency Questionnaire for the Japanese

We have developed a short food frequency questionnaire (FFQ) for use in assessing diet quality for Japan, with special reference to the prevention of non-communicable diseases. Here, we assessed the ranking performance of this FFQ and its reproducibility. We developed a 28-item (21 food groups and 7 beverage) FFQ with consideration to both Japanese dietary culture and evidence of disease prevention. Twenty-four university faculty members participated in the validation study. They completed 3-day photographic food record and answered the FFQ on the next day of the last food record (time 1) and a week later (time 2). We calculated Spearman correlation coefficients between intakes of food groups from photographic food records and the consumption frequency from the FFQs (ranking ability) and between the consumption frequency of food groups from the FFQs (time 1 and time 2) (reproducibility). Spearman correlation coefficients between the food records and FFQ (time 1) ranged from −0.12 to 0.86 (median 0.51). These values were comparable to those in comparison with FFQ (time 2). After energy adjustment of intakes from the food records, the corresponding values were somewhat weakened for many food groups. The correlation coefficients between two FFQs ranged from 0.14 to 0.96 (median 0.79). The short FFQ showed acceptable reproducibility and ability to rank the consumption of most food groups.     

出入境人员心电图检测结果的分析报告

[目的]了解出入境人员中心电图异常情况,及时发现心脏病患者,提高防护意识,保护旅行者健康.[方法]对2368名出入境人员进行心电图检查.[结果]共检出心电图异常者273例,检出率为11.53%,其中以60岁以上人员检出率最高,为20.34%.不同人群之间检出率有明显不同.各年龄组心电图变化各有不同.[结论]60岁以上人群为心脏病高发人群,应作为重点监测对象,并应有针对性的对其做好旅行健康宣传教育工作.     

福州口岸出入境人员心电图分析

〔目的〕通过对福州口岸出入境人员心电图检查结果进行分析,探讨不同类别出入境人员心电图的异常情况。〔方法〕对2005年1～6月5737名出入境人员心电图检查结果进行分析。〔结果〕本组心电图异常检出率高达30.6%;男女检出率差异有显著性;但主要异常心电图检出率为6.3%,不同出入境人群间异常心电图检出率差异无显著性;主要异常心电图检出率以入境人员和出国探亲人员较高,公、商务人员最低。〔结论〕福州口岸不同人群心电图异常检出率较高,加强对出入境人员中主要异常心电图的监测,加大卫生健康宣传咨询力度,对防止和降低心血管疾病意外事件的发生有积极意义。     

温州口岸出入境人员心电图检测结果分析

[目的]通过对出入境人员的心电图检测结果的分析，了解该人群心血管疾病的分布情况，以便更好地开展心血管疾病的防治工作。[方法]对2001年6月-2005年5月经温州口岸出入境的87606名出入境人员的心电图检查异常结果进行分析。[结果]共检出心电图异常2540例，检出率为2．90％，按照心电图异常检出率高低依次为：早搏、完全性右束支传导阻滞、预激综合征、工度房室传导阻滞、左心室肥大、房颤、心肌缺血、左前分支传导阻滞、右心室肥大、左房负荷过重、完全性左束支传导阻滞、左房心律、陈旧性心肌梗塞、房性心动过速、右位心等。[结论]认真做好心血管疾病的监测工作，为出入境人员提供及时、有效的健康指导十分重要。     

The Reproducibility and Relative Validity of a Food Frequency Questionnaire for Identifying Iron-Related Dietary Patterns in Pregnant Women

Analyzing pregnant women’s iron intake using dietary patterns would provide information that considers dietary relationships with other nutrients and their sources. The objective of this study was to evaluate the reproducibility and relative validity of a Qualitative Food Frequency Questionnaire to identify iron-related dietary patterns (FeP-FFQ) among Mexican pregnant women. A convenience sample of pregnant women (n = 110) completed two FeP-FFQ (FeP-FFQ1 and FeP-FFQ2) and a 3-day diet record (3DDR). Foods appearing in the 3DDR were classified into the same food groupings as the FeP-FFQ, and most consumed foods were identified. Exploratory factor analysis was used to determine dietary patterns. Scores were compared (FeP-FFQ for reproducibility and FeP-FFQ1 vs. 3DDR for validity) through intraclass correlation coefficients (ICC), cross-classification, Bland–Altman analysis, and weighed Cohen kappa (κw), using dietary patterns scores tertiles. Two dietary patterns were identified: “healthy” and “processed foods and dairy”. ICCs (p < 0.01) for “healthy” pattern and “processed foods and dairy” pattern were 0.76 for and 0.71 for reproducibility, and 0.36 and 0.37 for validity, respectively. Cross-classification and Bland–Altman analysis showed good agreement for reproducibility and validity; κw values showed moderate agreement for reproducibility and low agreement for validity. In conclusion, the FeP-FFQ showed good indicators of reproducibility and validity to identify dietary patterns related to iron intake among pregnant women.     

国际带工非淋菌性尿道炎的流行病学研究

[目的]通过对辽宁省的中韩航线国际带工的非淋菌性尿道炎／宫颈炎(NGu)流行病学调查，掌握这一人群的NGU的发病现状、分布特点及相关因素，为制定相应的防治对策提供科学依据。[方法]对往返中韩航线的278名国际带工进行NGU的临床、实验室检查，对数据资料采用SPSS10．0统计软件进行统计学分析。[结果]带工NGU的感染率明显高于正常人群，为8．27％；从事带工职业的时间是NGU的危险因素(OR=1．220，95％CI=1．013—1．468)：此外，带工的性别(OR=2．608，95％CI=1．043—6．521)、国籍(OR=0．215，95％CI=0．072—0．642)与感染NGU密切相关；特点为女性NGU感染率显著高于男性，中国籍带工高于韩国籍带工。[结论]国际带工是性传播疾病的高危人群；从事带工这一职业是感染性病的危险因素；对国际带工实施有效的干预措施，是防止性病、艾滋病传播的重要手段。     

Reproducibility and Validity of a Food Frequency Questionnaire among Vietnamese in Ho Chi Minh City

Objective: Our objective was to assess the reproducibility and validity of a food frequency questionnaire (FFQ) among individuals living in Ho Chi Minh City, Vietnam.

Methods: A total of 116 food items in our FFQ were selected by ranking food items according to their contribution to the population intake of nutrients, based on multiple 24-hour recalls (24HRs) from 144 participants in July 2001. The FFQ was validated by using three 24HRs for 118 men and women in Ho Chi Minh City, Vietnam in August 2002. The reproducibility of the FFQ was assessed by repeated administration at 7 ± 3.4 days.

Results: The reproducibility study showed that Spearman correlation coefficients, adjusted for energy intake, ranged from 0.47 to 0.72, and that weighted kappa values ranged from 0.42 for lipid to 0.65 for potassium. In the validation study, correlation coefficients, adjusted for energy intake, between the FFQ and the 24HRs ranged from 0.16 (calcium) to 0.45 (retinol). The proportion of subjects classified by the FFQ into the same third as determined by the 24HRs was between 42% and 62%.

Conclusions: This food frequency questionnaire measured the usual intake of major nutrients for Vietnamese adults living in Ho Chi Minh City and its urban area, where dietary patterns are similar to those of the Vietnamese population.