Journal of Preventive Medicine and Public Health

Original Article

Teleworking Survey in Saudi Arabia: Reliability and Validity of Arabic Version of the Questionnaire: Heba Yaagoub AlNujaidi, Mehwish Hussain, Sama’a H. AlMubarak, Asma Saud AlFayez, Demah Mansour AlSalman, Atheer Khalid AlSaif, Mona M. Al-Juwair; J Prev Med Public Health. 2022;55(6):578-585. Published online November 18, 2022; DOI: https://doi.org/10.3961/jpmph.22.242

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Abstract PDF Supplementary Material: Objectives
This study aimed to adapt the survey questionnaire designed by Moens et al. (2021) and determine the validity and reliability of the Arabic version of the survey in a sample of the Saudi population experiencing teleworking.
Methods
The questionnaire includes 2 sections. The first consists of 13 items measuring the impact of extended telework during the coronavirus disease 2019 (COVID-19) crisis. The second section includes 6 items measuring the impact of the COVID-19 crisis on self-view of telework and digital meetings. The survey instrument was translated based on the guidelines for the cultural adaptation of self-administrated measures.
Results
The reliability of the questionnaire responses was measured by Cronbach’s alpha. The construct validity was checked through exploratory factor analysis followed by confirmatory factor analysis (CFA) to further assess the factor structure. CFA revealed that the model had excellent fit (root mean square error of approximation, 0.00; comparative fit index, 1.0; Tucker-Lewis index, 1; standardized root mean squared residual, 0.0).
Conclusions
The Arabic version of the teleworking questionnaire had high reliability and good validity in assessing experiences and perceptions toward teleworking. While the validated survey examined perceptions and experiences during COVID-19, its use can be extended to capture experiences and perceptions during different crises.; Summary

Brief Report

Reliability and Validity of a Life Course Passive Smoke Exposure Questionnaire in an Australian Cohort From Childhood to Adulthood: Chigozie Ezegbe, Costan G. Magnussen, Amanda Louise Neil, Marie-Jeanne Buscot, Terence Dwyer, Alison Venn, Seana Gall; J Prev Med Public Health. 2021;54(2):153-159. Published online March 10, 2021; DOI: https://doi.org/10.3961/jpmph.20.559

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Objectives
Life course exposure to passive smoke may predict health, but there are few validated measures. We tested the reliability and validity of a retrospective life course passive smoking questionnaire.
Methods
Participants from the third follow-up of the Childhood Determinants of Adult Health study (2014-2019, ages 36-49 years) retrospectively reported mother/father/other household member smoking when living at home during childhood, including duration (years) and smoking location (never/sometimes/always inside house). The severity of exposure index (SEI; sum of mother/father/other years smoked multiplied by smoking location), cumulative years of exposure (CYE; sum of mother/father/other years), and total household smokers (THS) were derived. The reliability of retrospective passive smoking reports was examined with intraclass correlation coefficients (ICCs) using household smoking reported 34 years earlier in 1985 by participants when aged 7-15 years. Construct validity was examined by correlating retrospective passive smoking with participants’ smoking in adulthood and lung function in childhood and adulthood.
Results
Among 2082 participants (mean±standard deviation [SD], 45.0±2.5 years; 55.2% females), THS ranged from 0 to 5 (mean± SD, 0.9±1.0), CYE ranged from 0 to 106 (mean±SD, 10.5±13.9), and SEI ranged from 0 to 318 (mean±SD, 24.4±36.0). Retrospective measures showed moderate agreement with total household smokers reported in childhood (ICC, 0.58 to 0.62). The retrospective measures were weakly but significantly (p<0.05) correlated with participants’ smoking (r=0.13 to 0.15) and lung function (r= -0.05 to -0.06).
Conclusions
The retrospective passive smoking questionnaire showed reasonable reliability and validity. This measure may be useful for epidemiological studies.

Summary

Citations

Citations to this article as recorded by

Childhood secondhand smoke exposure and respiratory disease mortality among never-smokers: the Japan collaborative cohort study for evaluation of cancer risk
Haruna Kawachi, Masayuki Teramoto, Isao Muraki, Kokoro Shirai, Kazumasa Yamagishi, Akiko Tamakoshi, Hiroyasu Iso
Journal of Public Health.2023; 45(3): 604. CrossRef

Original Articles

Verification of the Reliability and Validity of the Short Form 36 Scale in Indonesian Middle-aged and Older Adults: Novita Intan Arovah, Kristiann C. Heesch; J Prev Med Public Health. 2020;53(3):180-188. Published online April 14, 2020; DOI: https://doi.org/10.3961/jpmph.19.324

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Abstract PDF Supplementary Material

Objectives
The Short Form 36 (SF-36) questionnaire is increasingly being used to measure health-related quality of life (HRQoL) in Indonesia. However, evidence that it is valid for use in Indonesian adults is lacking. This study assessed the validity and reliability of the SF-36 in Indonesian middle-aged and older adults.
Methods
Adults aged 46-81 years (n=206) in Yogyakarta, Indonesia completed the SF-36, another measure of HRQoL (the EuroQoL visual analogue scale [EQ-VAS]), and measures assessing their demographic characteristics. Fifty-four percent (n=121) completed the SF-36 measure again 1 week later. Confirmatory factor analysis was conducted to confirm the factor structure of the SF-36. Internal consistency reliability was estimated using Cronbach’s alpha, and test-retest reliability was assessed using intraclass correlations. Convergent and discriminant validity were assessed by computing correlations among SF-36 subscales, between subscales and the 2 component scores, and between component scores and EQ-VAS scores.
Results
Most scaling assumptions were met. The hypothetical factor structure fit the data poorly (root mean square error of approximation [RMSEA]=0.108) and modification was required for a good fit (RMSEA=0.060). Scores on all subscales demonstrated acceptable internal consistency (α>0.70) and test-retest reliability (r>0.70). Divergent validity was supported by weak to moderate interscale correlations (r=0.19 to 0.64). As expected, the 2 summary scores were moderately to strongly correlated with the EQ-VAS (r>0.60).
Conclusions
The findings adequately support the use of SF-36 in Indonesian middle-aged and older adults, although the optimal algorithm for computing component scores in Indonesia warrants further investigation.

Summary

Citations

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Comparisons between US norm-based two-component and Japanese norm-based three-component SF-36 summary scores in systemic lupus erythematosus patients
Sayuri Yamashita, Yasuhiro Katsumata, Naoko Konda, Rangi Kandane-Rathnayake, Eric F Morand, Masayoshi Harigai
Modern Rheumatology.2023; 33(3): 517. CrossRef
Health measurement instruments and their applicability to military veterans: a systematic review
Jane Jomy, P Jani, F Sheikh, R Charide, J Mah, R J Couban, B Kligler, A J Darzi, B K White, T Hoppe, J W Busse, D Zeraatkar
BMJ Military Health.2023; : e002219. CrossRef
ПРИМЕНЕНИЕ ПАРАМЕТРИЧЕСКИХ И ОПРОСНИКОВЫХ МЕТОДОВ ИССЛЕДОВАНИЯ ДИСКОГЕНННОГО БОЛЕВОГО СИНДРОМА У ВЗРОСЛЫХ
В. В. Трефилова, Н. А. Шнайдер
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Hafiz Muhammad Almas Sabir, . Maira, Amna Tariq , Maryam Naveed Sheikh, Hamna Rehman, Tamjeed Ghaffar, Kainat Malik, Urooj Manzoor, Kaiynat Shafique
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Nwachukwu Andrew Egbunike
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Samuel Asante, Grace Karikari
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V. V. Trefilova, N. A. Shnayder, M. A. Novitsky, O. A. Ovdienko, Z. A. Nurgaliev
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F Novianto, Z Zulkarnain, D Ardiyanto, A Triyono, U Nisa, P R W Astana, U Fitriani
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Lourdes Sukeyko Matta Zamudio
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Development of a Social Contact Survey Instrument Relevant to the Spread of Infectious Disease and Its Application in a Pilot Study Among Korean Adults: Hyang Soon Oh, Youngran Yang, Mikyung Ryu; J Prev Med Public Health. 2020;53(2):106-116. Published online February 9, 2020; DOI: https://doi.org/10.3961/jpmph.19.251

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to develop a valid social contact survey instrument and to verify its feasibility for use among Korean adults.
Methods
The Delphi technique was used to develop an instrument to assess social contacts, which was then applied in a cross-sectional pilot study. A panel of 15 medical professionals reviewed the feasibility and validity of each item. The minimum content validity ratio was 0.49. Thirty participants used the developed measure to record contacts during a 24-hour period.
Results
After a systematic review, the survey instrument (parts I and II) was developed. Part I assessed social contact patterns over a 24-hour period, and part II assessed perceptions of contacts in daily life and preventive behaviors (hand hygiene and coughing etiquette). High validity and feasibility were found. In the pilot study, the 30 participants had a combined total of 198 contacts (mean, 6.6 daily contacts per person). The participants’ age (p=0.012), occupation (p<0.001), household size (p<0.001), education (p<0.001), personal income (p=0.003), and household income (p<0.001) were significantly associated with the number of contacts. Contacts at home, of long duration, and of daily frequency were relatively likely to be physical. Assortative mixing was observed between individuals in their 20s and 50s. Contact type differed by location, duration, and frequency (p<0.001).
Conclusions
The developed social contact survey instrument demonstrated high validity and feasibility, suggesting that it is viable for implementation.

Summary

Korean summary
본 연구에서는 감염접촉전파에 대한 인식과 사회적접촉을 측정 도구를 델파이 방법으로 개발하여 국내최초로 한국 성인의 사회적접촉을 측정하였다. 참여자 30명은 24시간 동안 총 198명을 접촉하였으며(6.6명/일/인), 접촉자수는 연령 (p=0.012), 직업(p<0.001), 가구수 (p<0.001), 교육수준 (p<0.001), 개인소득 (p=0.003), 가구소득 (p<0.001)에 따라 차이가 있었다. 동질성 혼합(assortative mixing)은 20대와 50대에서 보였으며, 접촉유형은 접촉장소, 접촉기간, 접촉빈도에 따라 유의하였다(p<0.001). 향후 국내 사회적 접촉 양상과 특성에 관한 전국적인 후속연구를 제언한다.

Citations

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A pilot study investigating the social contact patterns of Korean elderly
Hyang Soon Oh, Sun Young Jeong, Youngran Yang
Public Health Nursing.2021; 38(5): 926. CrossRef
Prospective Diary Survey of Preschool Children's Social Contact Patterns: A Pilot Study
Hyang Soon Oh, Mikyung Ryu
Child Health Nursing Research.2020; 26(4): 393. CrossRef

Validity of Self-reported Stroke and Myocardial Infarction in Korea: The Health Examinees (HEXA) Study: Sunho Choe, Joonki Lee, Jeeyoo Lee, Daehee Kang, Jong-Koo Lee, Aesun Shin; J Prev Med Public Health. 2019;52(6):377-383. Published online November 12, 2019; DOI: https://doi.org/10.3961/jpmph.19.089

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Abstract PDF

Objectives
Self-reported disease history is often used in epidemiological studies. In this study, we acquired the hospital records of subjects who self-reported stroke or myocardial infarction (MI) and evaluated the validity of the participants’ self-reported disease history. We also determined the level of agreement between specialists and non-specialists.
Methods
Among the participants in the Health Examinees study, 1488 subjects self-reported stroke or MI during 2012-2017, and medical records were acquired for the 429 subjects (28.8%) who agreed to share their medical information. Each record was independently assigned to 2 medical doctors for review. The records were classified as ‘definite,’ ‘possible,’ or ‘not’ stroke or MI. If the doctors did not agree, a third doctor made the final decision. The positive predictive value (PPV) of self-reporting was calculated with the doctors’ review as the gold standard. Kappa statistics were used to compare the results between general doctors and neurologists or cardiologists.
Results
Medical records from 208 patients with self-reported stroke and 221 patients with self-reported MI were reviewed. The PPV of self-reported disease history was 51.4% for stroke and 32.6% for MI. If cases classified as ‘possible’ were counted as positive diagnoses, the PPV was 59.1% for stroke and 33.5% for MI. Kappa statistics showed moderate levels of agreement between specialists and non-specialists for both stroke and MI.
Conclusions
The validity of self-reported disease was lower than expected, especially in those who reported having been diagnosed with MI. Proper consideration is needed when using these self-reported data in further studies.

Summary

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Stressful life events and heart disease and stroke: A study among Portuguese older adults
Ana Quaresma, Elisabete Alves, Silvia Fraga, Ana Henriques
Stress and Health.2024;[Epub] CrossRef
Validation of self-reported cardiovascular problems in childhood cancer survivors by contacting general practitioners: feasibility and results
Eva-Maria Hau, Tomáš Sláma, Stefan Essig, Gisela Michel, Laura Wengenroth, Eva Bergstraesser, Nicolas X. von der Weid, Christina Schindera, Claudia E. Kuehni
BMC Primary Care.2024;[Epub] CrossRef
Association of the amount of alcohol consumption with change in skeletal muscle and fat mass among Korean adults
Jihun Song, Seulggie Choi, Sun Jae Park, Sung Min Kim, Yoosun Cho, Gyeongsil Lee, Ji Soo Kim, Sang Min Park
Alcohol.2023; 111: 9. CrossRef
History of Breastfeeding and Stroke Prevalence Among Parous Females: Findings from the National Health and Nutrition Examination Survey, 1999–2012
Gina M. Richardson, Emily Mitchell, Kalera Stratton, Laura R. Kair, Lynn M. Marshall
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Xuanli Chen, Siyuan Liu, Jiadong Chu, Wei Hu, Na Sun, Yueping Shen
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Objectively Measured Built Environments and Cardiovascular Diseases in Middle-Aged and Older Korean Adults
Eun Young Lee, Jungsoon Choi, Sugie Lee, Bo Youl Choi
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Research Support, Non-U.S. Gov't

The Validity and Reliability of a Screening Questionnaire for Parkinson's Disease in a Community.: Jong Hun Kim, Hae Kwan Cheong, Chong Sik Lee, Sung Eun Yi, Kun Woo Park; J Prev Med Public Health. 2010;43(1):9-17.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.9

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Abstract PDF

OBJECTIVES
Parkinson's disease is one of the most common neurodegenerative diseases in the elderly population. In order to estimate the prevalence of Parkinson's disease in the community, the application of a good screening tool is essential. We evaluated the validity and reliability of a Parkinson's disease screening questionnaire and propose an alternative measure to improve its validity for use in community surveys. METHODS: We designed the study in a three-phase approach consisting of a screening questionnaire, neurologic examination, and confirmatory examination. A repeated survey was administered to patients with disease detected in the community and on 150 subjects. We examined internal consistency using Cronbach's alpha test, test-retest reliability using the kappa statistic, and validity using sensitivity, specificity, and ROC curves. Unadjusted odds ratios were utilized for the estimation of weights for each questionnaire item. RESULTS: The Cronbach's alpha of the questionnaire was 0.708. The kappa statistic for test-retest reliability was good to generally fair in most of the items. When newly proposed weighting scores were used, the optimum cut-off value was 7/8. When cut-off value was 5/6 for surveying prevalence in a community, the sensitivity was 0.98, and the specificity was 0.61, with simultaneous improvement in reliability. CONCLUSIONS: We recommend 5/6 as the ideal cut-off value for the survey of PD prevalence in community. This questionnaire designed for the Korean community could help future epidemiologic studies of PD.

Summary

Citations

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Severity of Daytime Sleepiness and Parkinsonian-Like Symptoms in Korean Adults Aged 50–64 Years
Chol Shin, Regina E. Y. Kim, Robert J. Thomas, Chang-Ho Yun, Seung Ku Lee, Robert D. Abbott
Journal of Clinical Neurology.2022; 18(1): 33. CrossRef
Development of a symptoms-based thyroid risk questionnaire to screen for hypothyroidism in India
KM Prasanna Kumar, BipinKumar Sethi, SanjayP Khare, Mahesh Padsalge, AnadyaPrakash Tripathi, Milind Bhole, DyotonaSen Roy
Thyroid Research and Practice.2021; 18(2): 74. CrossRef
Clinical utility of the Epworth sleepiness scale
Nathan A Walker, Jag Sunderram, Peng Zhang, Shou-en Lu, Matthew T Scharf
Sleep and Breathing.2020; 24(4): 1759. CrossRef
A validation of a self-administered screening test for Parkinson's disease
Michele K. York, Jared F. Benge, Christine Hunter, Joseph Jankovic
Journal of the Neurological Sciences.2020; 418: 117116. CrossRef
Overview of the Korean Longitudinal Study on Cognitive Aging and Dementia
Ji Won Han, Tae Hui Kim, Kyung Phil Kwak, Kayoung Kim, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Tae Hyun Kim, Seok Woo Moon, Jae Young Park, Joon Hyuk Park, Seonjeong Byun, Seung Wan Suh, Ji Young Seo, Yoonseop So, Seung-Ho Ryu, Jong Chul Youn, Kyoung
Psychiatry Investigation.2018; 15(8): 767. CrossRef
Validation of a Questionnaire for Distinguishing X-Linked Dystonia Parkinsonism From Its Mimics
Jose Danilo B. Diestro, Mark Angelo C. Ang, Mark Willy L. Mondia, Paul Matthew D. Pasco
Frontiers in Neurology.2018;[Epub] CrossRef
Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review
Alain Lekoubou, Justin B Echouffo-Tcheugui, Andre P Kengne
BMC Public Health.2014;[Epub] CrossRef
Screening for Parkinson syndrome in a Chinese rural population: re-examination of a historic questionnaire
Ying LIU, Jin-hu FAN, Wen CHEN, Zhi-yu NIE, You-lin QIAO, Lin ZHANG
Chinese Medical Journal.2013; 126(5): 819. CrossRef
Prediction Model of Parkinson's Disease Based on Antiparkinsonian Drug Claims
F. Moisan, V. Gourlet, J.-L. Mazurie, J.-L. Dupupet, J. Houssinot, M. Goldberg, E. Imbernon, C. Tzourio, A. Elbaz
American Journal of Epidemiology.2011; 174(3): 354. CrossRef

Review

Identification and Application of Biomarkers in Molecular and Genomic Epidemiologic Research.: Kyoung Mu Lee, Sohee Han, Woong Yang Park, Daehee Kang; J Prev Med Public Health. 2009;42(6):349-355.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.349

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Abstract PDF

Biomarkers are characteristic biological properties that can be detected and measured in a variety of biological matrices in the human body, including the blood and tissue, to give an indication of whether there is a threat of disease, if a disease already exists, or how such a disease may develop in an individual case. Along the continuum from exposure to clinical disease and progression, exposure, internal dose, biologically effective dose, early biological effect, altered structure and/or function, clinical disease, and disease progression can potentially be observed and quantified using biomarkers. While the traditional discovery of biomarkers has been a slow process, the advent of molecular and genomic medicine has resulted in explosive growth in the discovery of new biomarkers. In this review, issues in evaluating biomarkers will be discussed and the biomarkers of environmental exposure, early biologic effect, and susceptibility identified and validated in epidemiological studies will be summarized. The spectrum of genomic approaches currently used to identify and apply biomarkers and strategies to validate genomic biomarkers will also be discussed.

Summary

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Could 8-oxoguanine DNA glycosylase 1 Ser326Cys polymorphism be a biomarker of susceptibility in cancer?
Bensu Karahalil, Ayşe Başak Engin, Erdem Coşkun
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Validation Studies

Validity of Measles Immunization Certificates Submitted upon Enrollment in an Elementary School in Korea.: Kunsei Lee, Hyeongsu Kim, Eunyoung Shin, Youngtaek Kim, Sounghoon Chang, Jaewook Choi; J Prev Med Public Health. 2009;42(2):104-108.; DOI: https://doi.org/10.3961/jpmph.2009.42.2.104

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Abstract PDF

OBJECTIVES
To increase the booster vaccination rate, the Korean government legislated a measles vaccination for elementary school students in 2001, requiring parents to submit a certificate of vaccination upon the admission of the students to elementary school. The purpose of this study was to evaluate the validity of measles vaccination certificates which were issued to parents. METHODS: Using questionnaire survey data of 890 general practitioners and 9,235 parents in 2005, we investigated the evidence for booster vaccination certificates of measles. RESULTS: In the survey of general practitioners, 59.5% of the certificates depended on the medical records of clinic, 13.5% was immunization booklets, 23.7% was re-immunizations, 1.9% was confirmation of record of other clinics, and 1.4% was parents' statements or requests without evidence. In the survey of parents, 36.2% of the certificates depended on the medical records of clinic, 43.4% was immunization booklets, 18.0% was reimmunizations, and 2.4% was parents statements or requests without evidence. CONCLUSIONS: Our findings show that a majority of the booster vaccination certificates of measles was issued on the basis of documented vaccinations and it means that the implementation of the law requiring the submission of elementary school students' vaccination certificates has been very successful in Korea.

Summary

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Increasing vaccination coverage: The school entry vaccination record check program in Guizhou Province China, 2003–2018
Shuyan Zuo, Dayong Zhang, Qiuyue Mu, Lifang Dai, Wen Du, Fei Xu, Jun Feng, James Dawson Heffelfinger
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Eun Seong Kim, Young June Choe, Heeyeon Cho, You-Jin Kim, Hee Sook Yoon, Jeong-Sun Yang, Kisoon Kim, Geun-Ryang Bae, Duk-hyoung Lee
Vaccine.2012; 30(23): 3355. CrossRef

Original Articles

Assessment of the Availability of Health Insurance Data for Epidemiologic Study of Childhood Aseptic Meningitis.: Sue Kyung Park, Hae Kwan Cheong, Moran Ki, Young Mo Son, Ho Kim; Korean J Prev Med. 2003;36(4):349-358.

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Abstract PDF: OBJECTIVES
Aseptic meningitis is a major cause of Korean childhood morbidity late spring and early summer. However, the nationwide incidences of the disease have not been reported. This study was conducted to evaluate the availability of National Health Insurance data (NHID) for the study of an epidemiological trend in the surveillance of aseptic meningitis in children. METHODS: All the claims, under A87, A87.8, and A87.9 by ICD-10, among children below 15 years of age, to the National Health Insurance Corporation, between January and December 1998, were extracted. A survey of the medical record of 3, 874 cases from 136 general hospitals was performed. The availability of the NHID was evaluated by the three following methods: 1) The diagnostic accuracy (the positive predictive value = proportion of the confirmed aseptic meningitis among the subjects registered as above disease-codes in NHID) was evaluated through a chart review, and according to age, gender, month and region of disease-occurrence. 2) The distribution of confirmed cases was compared with the distribution of total subjects from the NHID, for subjects in General hospitals, or the subjects surveyed. 3) The proportion of confirmed CSF test was confirmed, and the relating factor, which was the difference in CSF-test rate, analyzed. RESULTS: Among 3, 874 cases, CSF examinations were performed on 1, 845 (47.6%), and the CSF-test rates were different according to the medical utility (admission vs. OPD visit) and the severity of the symptoms and signs. The diagnostic accuracy for aseptic meningitis, and during the epidemic (May-Aug) and sporadic (Sept-Apr) periods, were 85.0 (1, 568/1, 845), 86.0 (1, 239/1, 440) and 81.2% (329/405), respectively. The distributions by age, sex, month or period (epidemic/sporadic) and region, in the confirmed cases, were similar to those in the NHID, in both the subjects at General hospitals and in those surveyed, to within +/-7%. CONCLUSIONS: In this paper, the NHID for the subjects registered with an aseptic meningitis disease-code might be available for an epidemiological study on the incidence-estimation of childhood aseptic meningitis, as the NHID could include both the probable and definite cases. On the basis of this result, further studies of time-series and secular trend analyses, using the NHID, will be performed.; Summary

A Trial for Development of Health Profile (KHP 1.0) to Measure the Self-Perceived Health Status of Korean.: Jin Seon Yang, Jin Ho Chun; Korean J Prev Med. 2003;36(1):11-23.

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Abstract PDF: OBJECTIVES
The 1990s has seen advances in the conceptualization of self-perceived health status which has important roles for individual health and the quality of life. Many types of standardized questionnaires have been developed with the current wide use of SF-36, NHP, andEuroQol. However, the outcomes of these tools may be different with regard to regional, cultural and emotional backgrounds. The purpose of this study was to trial the development of a Korean Health Profile (KHP 1.0) to measure the self-perceived health stati of Koreans. METHODS: The KHP 1.0 was designed on the basis of the Medical Outcome Study Form 36 (SF-36), the Nottingham Health Profile (NHP), and the EuroQOL. It was composed of 9 scales; physical functioning, role limitation-physical, pain, general health, energy, social isolation, sleep, role limitation-emotional, and emotional health. Self-reported chronic disease conditions, and the Zung's Self-Rating Depression Scale (SDS), were also checked for the evaluation of clinical validity. This study was conducted, from December 2000 to January 2001, on 800 middle-aged parents, with four high school students, with 100 retest sets being conducted two weeks later. From the 800 subjects there were 588 complete responses (effective response 73.5%). The reliability of the test-retest results, and the factor analysis on the validity of the KHP 1.0 components, were evaluated using the SPSS (ver 10.0) software. RESULTS: The reliability of the KHP 1.0 was good with Cronbach's alpha (> 0.6), test-retest correlation coefficients (> 0.5), but with no significant differences from the paired t-test. From the psychometric validity tests, the 9 scales of the KHP 1.0 were divided into two components; physical and mental, and trimmed to the established model with 55% of the total variance, with the exception of role limitation-emotional. The clinical validity on the basis of the comparison for the four characteristic groups; healthy, physical conditions only, mental conditions only, and physical and mental conditions were also good. CONCLUSIONS: The KHP 1.0 appears to be a valid measurement tool of self-perceived health stati of Koreans, although there are limitations, i.e. sample size was too small, a limited number of middle-aged subjects, and it was based on unconfirmed diagnoses, etc. Therefore, further study is required to standardize the assessment.; Summary

The Development of Physical Functioning Scale for Community-Dwelling Older Persons.: Yun Hwan Lee, Kyung Jong Lee, Geun Shik Han, Soo Jin Yoon, Yeon Kyung Lee, Chan Ho Kim, Jeong Lim Kim; Korean J Prev Med. 2002;35(4):359-374.

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Abstract PDF: OBJECTIVES
To develop a physical functioning instrument for older adults living in the community. METHODS: A representative sample of 979 people aged 65 years or over were interviewed in-person. Of these, 199 people also completed a detailed in-hospital examination. The scale items were selected based on the frequency of endorsement, along with the item-total and inter-item correlations. The associations of the scale with their physical performance and clinical examination were analyzed to evaluate the criterion-related validity. Construct validity was assessed using factor analysis, and internal consistency through Cronbach's alpha and item-total correlations. Test-retest reliability was measured by agreement between the household survey and the repeat survey at the in-hospital examination. RESUJLTS: Initially, 23 items on the level of difficulty, ranging from no difficulty to an inability to complete a task, with the specific mobility and self-care tasks were included. Those with a high frequency of endorsement and a low inter-item or item-total correlations were excluded, resulting in a 10-item Physical Functioning (PF) scale. Equal weights were given to each item and a summated score was calculated. Significant associations were found between the PF scores and the physical performance, survey and clinical data. The scale revealed a 2-factor (mobility and self-care) structure. Cronbach's alpha was 0.92 and the item-total correlations were in the 0.63 to 0.78 range. Pearson's correlations for the test-retest ranged between 0.56 and 0.61. CONCLUSIONS: The newly developed Physical Functioning (PF) scale showed good psychometric properties in older people. Further work, however, is needed to improve its sensitivity to discriminate higher levels of functioning, in addition to assessing its predictive value in detecting changes in health.; Summary

Analysis of Pap Smear Results over Twenty Year Period, 1979-1998.: Ji Won Han, Jin Ho Chun, Dae Hoon Jeong, Ki Tae Kim, Hye Kyoung Yoon; Korean J Prev Med. 2000;33(4):505-512.

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Abstract PDF: OBJECTIVE
To estimate the significance of the Pap smear as a screening tool for cervical cancer. METHODS: A total of 79,840 Pap smear results performed at Pusan Paik Hospital over the 20 year period from 1979 to 1998 were collected and analyzed. RESULTS: The number of Pap smear cases increased markedly during this period, and the results as a whole were classified as consisting of 96.4% normal and benign cytology, 2.2% pre-cancerous cytology, and 1.4% cervical cancer. The relative frequency of cervical cancer decreased from 1.6% in 1979 to 0.7% in 1998. About 64% of the Pap smears were distributed within the age range of 30 to 49 years, and the rate of cervical cancer increased with age, age of marriage and experience of childbirth (p<0.01). The overall agreement of Pap smear results with histologic diagnosis by one histologic degree was 92.7%(1,128/1,217) with 73 overestimated cases and 16 underestimated cases of Pap smear compared to histologic diagnosis. CONCLUSION: This result implies that the Pap smear is an excellent screening tool for cervical cancer with respect to both its scale and validity. Periodic and active Pap smear testing would be helpful for the secondary prevention of cervical cancer.; Summary

Validation of the International Classification of Diseases 10th Edition Based Injury Severity Score(ICISS).: Yoon Kim, Ku Young Jung, Chang Yup Kim, Yong Ik Kim, Youngsoo Shin; Korean J Prev Med. 1999;32(4):538-545.

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Abstract PDF: OBJECTIVE
To compare the predictive power of International Classification of Diseases 10th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with Trauma and Injury Severity Score(TRISS) and International Classification of Diseases 9th Edition Clinical Modification(ICD-9CM) based ICISS in the injury severity measure. METHODS: ICD-10 version of Survival Risk Ratios(SRRs) was derived from 47,750 trauma patients from 35 Emergency Centers for 1 year. The predictive power of TRISS, the ICD-9CM based ICISS and ICD-10 based ICISS were compared in a group of 367 severely injured patients admitted to two university hospitals. The predictive power was compared by using the measures of discrimination(disparity, sensitivity, specificity, misclassification rates, and ROC curve analysis) and calibration(Hosmer-Lemeshow goodness-of-fit statistics), all calculated by logistic regression procedure. RESULTS: ICD-10 based ICISS showed a lower performance than TRISS and ICD-9CM based ICISS. When age and Revised Trauma Score(RTS) were incorporated into the survival probability model, however, ICD-10 based ICISS full model showed a similar predictive power compared with TRISS and ICD-9CM based ICISS full model. ICD-10 based ICISS had some disadvantages in predicting outcomes among patients with intracranial injuries. However, such weakness was largely compensated by incorporating age and RTS in the model. CONCLUSIONS: The ICISS methodology can be extended to ICD-10 horizon as a standard injury severity measure in the place of TRISS, especially when age and RTS were incorporated in the model. In patients with intracranial injuries, the predictive power of ICD-10 based ICISS was relatively low because of differences in the classifying system between ICD-10 and ICD-9CM.; Summary

Development of Korean Neurobehavioral Test Battery - Assessment of the Validity of Traditional and Computerized Neurobehavioral Tests.: Jong Hak Chung, Chang Yoon Kim, Joon Sa Kong, Man Joong Jeon, Park Chin Hong; Korean J Prev Med. 1998;31(4):692-707.

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Abstract PDF: Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Digit Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol , Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, factor analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.; Summary

Reliability and Validity of the Korean Version of ISAAC Questionnaire.: Seong Woo Choi, Yeong Su Ju, Dae Sung Kim, Jae Yong Kim, Ho Jang Kwon, Dae Hee Kang, Sang Il Lee, Soo Hun Cho; Korean J Prev Med. 1998;31(3):361-371.

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Abstract PDF: Recent increases of asthma and allergies in childhood made the need for a standardized approach to international and regional comparisons of their prevalence and severity. To address these issues, "International Study of Asthma and Allergies in Childhood (ISAAC)" is currently underway. In Korea, "Nationwide Study of Asthma and Allergies in Korean Children" began in 1995 according to ISAAC protocol. ISAAC written and video questionnaires were used in this survey, but their reliability and validity were not evaluated properly yet. In this study, our aim was to evaluate the reliability and validity of two kinds of questionnaires and their usefulness in international and regional comparisons. The test and retest of two questionnaires were completed by male(n=110) and female(n=111) middle school students with two and three weeks interval each. Kappa(or weighted kappa) were calculated from each questions and validity coefficients were estimated from those statistics. In Korean version of written questionnaire, the questions for allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and food allergy proved to have high kappa values(or weighted kappa values) and validity coefficients and they can be used in further studies without any correction. But some questions about asthma(especially nocturnal cough, wheezing in exercise, and severe asthma) and drug allergy need to be revised for better understanding to study subjects. Video questionnaire has the same degree of reliability and validity when compared to written questionnaire and this is the unexpected result. Accordingly, it also need to be revised to overcome the racial and cultural differences of the study subjects. In conclusion, the Korean version of written and video questionnaires may be considered to be useful methods in international and regional comparisons of asthma and allergic diseases in childhood after correction of some questions.; Summary

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