Effect of the method of administration, mail or telephone, on the validity and reliability of a respiratory health questionnaire. The Spanish Centers of the European Asthma Study

J Clin Epidemiol. 1998 Oct;51(10):875-81. doi: 10.1016/s0895-4356(98)00063-8.


The European Community Respiratory Health Survey (ECRHS), a multinational survey, assesses and compares the prevalence of asthma among subjects, aged 20 to 44, in several European areas. In Spain, some participating centers have used mail and telephone as methods of questionnaire administration. The objective of the present study was to determine whether the validity and reliability of the questionnaire differed by method of administration. Reliability of the questionnaire was measured with the kappa index and the odds ratio of agreement, and validity with the sensitivity and specificity. This study found differences in the reliability of the questionnaires although these differences were more related to the questions themselves than to the method of administration. Among men, but not women, mailed questionnaires were more sensitive and telephone questionnaires more specific. We hypothesize that these differences in validity were due to the self-selection to more severe symptomatic subjects replying earlier and therefore to the mailed questionnaire. Combining different methods of administration was useful as it increased participation and was an adequate procedure to obtain information of good quality.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Asthma / epidemiology*
  • Correspondence as Topic*
  • Female
  • Health Status*
  • Health Surveys*
  • Humans
  • Male
  • Odds Ratio
  • Prevalence
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sex Factors
  • Spain / epidemiology
  • Surveys and Questionnaires / standards*
  • Telephone*