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Biases in Questionnaires

Introduction to Medicine II School Year 2010/2011 Class 8 , First Year. Fiction or Reality ?. Biases in Questionnaires. Regent Teacher: Altamiro Costa Pereira Supervisor Teachers: Cristina da Costa Santos and Luís Pinto. Summary. Introduction Importance of questionnaires Biases

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Biases in Questionnaires

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  1. Introduction to Medicine II School Year 2010/2011 Class 8, First Year Fiction or Reality? Biases in Questionnaires Regent Teacher: Altamiro Costa Pereira Supervisor Teachers: Cristina da Costa Santos and Luís Pinto

  2. Summary • Introduction • Importance of questionnaires • Biases • Types of biases • Importance of our work • Aim • Participants and Methods • Questionnaires • Expected Results • Results and Discussion • Conclusion • References

  3. Introduction The importance of questionnaires People’s Opinion Questionnaires •  Politics •  Religion •  Sports •  Science • Demography • Medicine • … Collected through Have applications in… (1) Bowling A. Mode of questionnaire administration can have serious effects on data quality. J Public Health (Oxf). 2005;27(3):281-91

  4. Introduction Biases Errors related to not measuring the situation that is intended to be measured. Sistematic mistakes or Biases: The way each question of a questionnaire is written may or may not influence the answer of the inquired person Biased Questionnaire (2) Choi BC, Noseworthy AL. Classification, direction, and prevention of bias in epidemiologic research. J Occup Med 1992;34:265-71.

  5. Types of Biases (5) Questionnaire Design Administration of Questionnaire Question Design • Insensitive measure • Forced choice • Sensitive question • Vague word • Overlapping interval • Ambiguous question • End aversion • Primacy and recency • Juxtaposed scale • Horizontal response format (3)Rodríguez MD, Llorca J. Bias. J Epidemiol Community Health. 2004. 58(8): 635-641. (4) Hunt DM, Magruder S, Bolon DS. Questionnaire format bias: when are juxtaposed scales appropriate: a call for further research. Psychol Reports 1995;77:931-41.

  6. Introduction Biases “A catalog of biases in questionnaires” (5) Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  7. Importance of the Work … it wasn’t foundany article which proves the influence of those biases in questionnaires. • There are several articles identifying possible biases. • BUT… (6) Sudman S, Bradburn NM. Asking questions: a practical guide to questionnaire design. San Francisco (CA): Jossey-Bass Pulishers; 1982. (7) Foddy W. Constructing questions for interviews and questionnaires: theory and practive in social research. Cambridge (UK): Cambridge University Press; 1993. (8) Choi BC, Pak AW. Bias, overview. In: Armitage P, Colton T, editors. Encyclopedia of biostatistics. Vol 1. Hoboken (NJ): John Wiley&Sons, Inc; 1998. p. 331-8. (9) Sackett DL. Bias in analytic research. J Chron Dis. 1979;32:51–63.

  8. Summary • Introduction • Importance of questionnaires • Biases • Types of biases • Importance of our work • Aim • Participants and Methods • Questionnaires • Expected Results • Results and Discussion • Conclusion • References

  9. Aim • Find out if the types of biases such as: • Question Design; • Questionnaire Design; • Administration of Questionnaire… • …Influence the answers given in a questionnaire. Could the way each question is madeaffect, in a significantway, the answers given by the inquired person?

  10. Summary • Introduction • Importanceofquestionnaires • Biases • Typesofbiases • Importanceofourwork • Aim • ParticipantsandMethods • Questionnaires • ExpectedResults • ResultsandDiscussion • Conclusion • References

  11. Participants and Methods “Utilização dos telemóveis pelos estudantes do primeiro ano do Mestrado Integrado em Medicina (MIM) da Faculdade de Medicina da Universidade do Porto (FMUP)” Question Design Questionnaire Design Administration of Questionnaires Other questions All the students of the first year of MIM from FMUP

  12. ParticipantsandMethods • Collect, organize andanalyse IBM SPSS STATISTICS 1

  13. ParticipantsandMethods • Website http://www.wix.com/fmupturma08/im11

  14. Summary • Introduction • Importanceofquestionnaires • Biases • Typesofbiases • Importanceofourwork • Aim • ParticipantsandMethods • Questionnaires • ExpectedResults • ResultsandDiscussion • Conclusion • References

  15. Questionnaires(9) Visual AnalogicalScale Questionnaire A1 Questionnaire A2

  16. Questionnaires Question design - ForcedChoice Questionnaire A1 Questionnaire A2 [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  17. Questionnaires Question design - Sensitivequestion Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  18. Questionnaires Questionnaire design - Juxtaposedscale Questionnaire A1 Questionnaire A2 (10) Hunt DM, Magruder S, Bolon DS. Questionnaire format bias: when are juxtaposed scales appropriate: a call for further research. Psychol Reports 1995;77:931-41.

  19. Questionnaires Question Design – ForcedChoice Questionnaire A1 5. Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  20. Questionnaires Question Design - Vague Word Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  21. Questionnaires Question Design - Overlappinginterval Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  22. Questionnaires Question Design - Ambiguousquestion Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  23. Questionnaires Questionnaire Design - Horizontal response format Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  24. Questionnaires AdministrationofQuestionnaire – Primacyandrecency Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  25. Summary • Introduction • Importanceofquestionnaires • Biases • Typesofbiases • Importanceofourwork • Aim • ParticipantsandMethods • Questionnaires • ExpectedResults • ResultsandDiscussion • Conclusion • References

  26. ExpectedResults Answers ≠ QuestionsofQuestionnaires A1 QuestionsofQuestionnaires A2

  27. ExpectedResults Thewayeachquestionismadeaffects, in a significantway, theanswersgivenbytheinquiredperson.

  28. Summary • Introduction • Importanceofquestionnaires • Biases • Typesofbiases • Importanceofourwork • Aim • ParticipantsandMethods • Questionnaires • ExpectedResults • ResultsandDiscussion • Conclusion • References

  29. ResultsandDiscussion * The total numberofstudentswhoshouldanswerthequestionnaires AI and A2 was 118 and 120, respectively. However, only 107 and 98 answeredbecausetheothersweren’tpresentwhenthequestionnairesweredelivered.

  30. ResultsandDiscussion Questionnaire A2 Questionnaire A1 Tests: Mann-Whitney • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  31. ResultsandDiscussion Questionnaire A2 Questionnaire A1 * Neutral questions (“Não sei”) weren’tconsidered. Tests: Chi-square 0% Mmissinganswers 21% “não sei” CI95%=[13%,29%] • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  32. ResultsandDiscussion Questionnaire A1 Questionnaire A2 Tests: Chi-square • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  33. ResultsandDiscussion Questionnaire A2 Questionnaire A1 Tests:Mann-Whitney (10) Hunt DM, Magruder S, Bolon DS. Questionnaire format bias: when are juxtaposed scales appropriate: a call for further research. Psychol Reports 1995;77:931-41.

  34. ResultsandDiscussion Questionnaire A1 Questionnaire A2 58% “Concordo/Discordo” CI95%=[49%;68%] 1 Missinganswer Tests:Chi-Square • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  35. ResultsandDiscussion Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  36. ResultsandDiscussion Questionnaire A1 Questionnaire A2 • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  37. ResultsandDiscussion Questionnaire A1 Questionnaire A2 Tests:Chi-Square • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  38. ResultsandDiscussion Questionnaire A1 Questionnaire A2 9% ofmissinganswers (IC95%= 3,3;14,7) 23% ofmissinganswers (IC95%= 15,0;31,0) • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  39. ResultsandDiscussion Questionnaire A1 Questionnaire A2 Tests: Chi-Square • [5] Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13.

  40. ResultsandDiscussion Limitations It’s very hard to write a biased questionnaire with only one bias per question.

  41. ResultsandDiscussion Limitations Wewant to understandifthere are significantdifferencesbetweenthequestionnaireconsideredbiasedandtheoneconsidered neutral. Inwhatwayisthat a limitation? Thesameinquiredpersonshouldanswerbothquestionnaires

  42. ResultsandDiscussion Limitations Minimize selectionbias Thequestionnaireswererandomlydistributed to theinquiredpeople

  43. ResultsandDiscussion Limitations • Thehomogeneityofthepopulation: • Same age • Samecourse • Samecollege

  44. ResultsandDiscussion Limitations Lackofsamplesizein some options Some statistical tests

  45. Summary • Introduction • Importanceofquestionnaires • Biases • Typesofbiases • Importanceofourwork • Aim • ParticipantsandMethods • Questionnaires • ExpectedResults • ResultsandDiscussion • Conclusion • References

  46. Conclusion Could the way each question is madeaffect, in a significantway, the answers given by the inquired person? Yes

  47. Conclusion Questionnaire A1 Questionnaire Design Juxtaposed Scale Questionnaire A1 Visual Analogical Scale

  48. Conclusion Some recommendations:  Use visualanalogicalscales; Presenceofneutral option; Mixingconcepts; Attention to theorderoftheoptions.

  49. Summary • Introduction • Importanceofquestionnaires • Biases • Typesofbiases • Importanceofourwork • Aim • ParticipantsandMethods • Questionnaires • ExpectedResults • Results • Discussion • Conclusion • References

  50. References [1] Bowling A. Mode of questionnaire administration can have serious effects on data quality. J Public Health (Oxf).2005;27(3):281-91. [2] Choi BC, Noseworthy AL. Classification, direction, and prevention of bias in epidemiologic research. J Occup Med 1992;34:265-71. [3]Rodríguez MD, Llorca J. Bias. J Epidemiol Community Health. 2004. 58(8): 635-641. [4]Hunt DM, Magruder S, Bolon DS. Questionnaire format bias: when are juxtaposed scales appropriate: a call for further research. Psychol Reports 1995;77:931-41. [5]Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005 Jan;2(1):A13. [6] Sudman S, Bradburn NM. Asking questions: a practical guide to questionnaire design. San Francisco (CA): Jossey-Bass Pulishers; 1982. [7] Foddy W. Constructing questions for interviews and questionnaires: theory and practice in social research. Cambridge (UK): Cambridge University Press; 1993. [8]Choi BC, Pak AW. Bias, overview. In: Armitage P, Colton T, editors. Encyclopedia of biostatistics. Vol 1. Hoboken (NJ): John Wiley&Sons, Inc; 1998. p. 331-8. [9]Sackett DL. Biasinanalyticresearch. J ChronDis. 1979;32:51–63. [10]Salant P, Dillman DA. How to conduct your own survey. New York: John Wiley & Sons, Inc; 1994.

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