A Parent Completed Questionnaire to Describe the Patterns of Wheezing and Other Respiratory Symptoms in Infants and Preschool Children

Aim: To develop a standardised and validated respiratory symptom questionnaire for use in epidemiological or follow up studies in infants and preschool children.

Methodology: After initial design and development, the questionnaire was administered to two cohorts of subjects, one recruited from a respiratory clinic and the other from a postnatal ward. The two cohorts then repeated the questionnaire, two weeks apart. The qualities of the questionnaire were assessed.

Results: Response rate to the initial questionnaire was 100% for the clinic based cohort and 64% for postnatally recruited families (total number of subjects 114). Questions showed good to moderate short term reliability (weighted kappa scores 0.47-0.7; average correct classification rates 0.74-0.91). Four domain concept scores showed excellent internal consistency (Cronbach alpha scores 0.87-0.95). Using principal component factor analysis, four new domains were devised showing acceptable construct validity and internal consistency. Criterion validity was assessed using a respiratory physician based diagnosis of asthma (RPBDA) as the gold standard for comparison. All eight scales in the questionnaire could significantly distinguish between infants with RPBDA and well or mildly symptomatic subjects.

Conclusion: We have developed a practical, acceptable questionnaire with eight concept domains for use in infants and preschool children. The questionnaire has strong construct validity and internal consistency with good short term reliability of questions. More detailed study of criterion validity and the responsiveness of the questionnaire is required using a larger population and including children with the different phenotypes of wheezy illness.