1. Introduction to Medicine II Class 6 Regent Teacher: Altamiro Pereira Supervisor Teachers: Cristina Santos and Gustavo Bacelar

2. Introduction Methods Results and Discussion Conclusion References 2

3. Introduction Introduction Methods Results and Discussion Conclusion References 3 The questionnaire design influences the quality of questionnaire results, which are also related to the choice of the scale used in the questionnaire 1. 1 Pires, M.D., G. Oliveira, and M. Behlau, Voice Activity and Participation Profile - VAPP administered in two different scales of response. J Soc Bras Fonoaudiol, 2011. 23(3): p. 297-300.

4. Introduction Introduction Methods Results and Discussion Conclusion References 4 Discordo totalmente Concordo totalmente 1 2 3 4 5 6 7 8 9 10 Discordo totalmente Concordo totalmente Visual Numeric Scale (VNS) 2 Visual Analogue Scale (VAS) 3 Numerical Rating Scale (NRS) 2 Hartman, J.M., et al., Tutorials in clinical research: part IV: recognizing and controlling bias. Laryngoscope, 2002. 112(1): p. 23-31. 3 Choi, B.C. and A.W. Pak, A catalog of biases in questionnaires. Prev Chronic Dis, 2005. 2(1): p. A13.

5. Introduction Introduction Methods Results and Discussion Conclusion References 5 Finding out: REPRODUCIBILITY of the scales AGREEMENT of the scales

6. Introduction Methods Methods Results and Discussion Conclusion References 6 Target Population o Students of Integrated Masters Degree in Medicine of FMUP, 1 st year and 1 st time, with classes of Introduction to Medicine II

7. Introduction Methods Methods Results and Discussion Conclusion References 7

8. Introduction Methods Methods Results and Discussion Conclusion References 8 Longitudinal study Confidential questionnaires

9. Introduction Methods Methods Results and Discussion Conclusion References 9 1 (NRS) 2 (VAS) 3 (VNS) 4 (NRS) 5 (VNS) 6 (VAS) 1 (NRS) 2 (VAS) 3 (VNS) 4 (VAS) 5 (NRS) 6 (VNS) Questionnaire AQuestionnaire B REPRODUCIBILITY AGREEMENT

10. No Introduction Methods Methods Results and Discussion Conclusion References 10 END START TARGET POPULATION BLOCK 5 BLOCK 1 QUESTIONNAIRE AQUESTIONNAIRE B 30 DAYS QUESTIONNAIRE BQUESTIONNAIRE A NoYes SPSS ANALYSIS Yes

11. Introduction Methods Methods Results and Discussion Conclusion References 11 In order to assess reproducibility and agreement we used: Bland and Altman plots Information Based Measure of Disagreement (IBMD) with respective 95% confidence intervals

12. Introduction Methods Methods Results and Discussion Conclusion References 12 Programed sample n=223 211 people answered at least one questionnaire Analysed sample n=133 (60%) (answered to both questionnaires)

13. Introduction Methods Results and Discussion Results and Discussion Conclusion References 13 n=133 Distribution of the gender of people who answered to both questionnaires

14. Introduction Methods Results and Discussion Results and Discussion Conclusion References 14 Question Quest. AQuest. B medianIQ rangemedianIQ range 1 – Uso com frequência a internet para fazer downloads 8483,5 2 – Jogo frequentemente on-line 0,51,90,21,2 3 - No meu estudo recorro frequentemente à internet 6,82,16,22,7

15. Introduction Methods Results and Discussion Results and Discussion Conclusion References 15 Question MedianIQ range 4 - Comunico com amigos/familiares frequentemente pela Internet NRS83,7 VAS7,14,4 5 - Acedo frequentemente a informação diária na Internet NRS63,5 VNS64 6 - Acedo frequentemente a motores de busca para pesquisa de informação VAS9,22,1 VNS92

16. 16 Introduction Methods Results and Discussion Results and Discussion Conclusion References

17. 17 Question 1 Uso com frequência a internet para fazer downloads Numeric Rating Scale Question 2 Jogo frequentemente on-line Question 3 No meu estudo recorro frequentemente à internet Visual Numeric Scale Discordo totalmente Concordo totalmente 1 2 3 4 5 6 7 8 9 10 Visual Analogue Scale Discordo totalmente Concordo totalmente [ -3,45 ; 3,87 ] [ -3,57 ; 3,47 ] [ -3,75 ; 3,79 ]

18. 18 ScalesnIBMD (95% CI) NRS1290,2 [0,17 ; 0,24] VAS1290,2 [0,17; 0,23] VNS1330,2 [0,17 ; 0,23] Information based measure of disagreement (IBMD) IBMD=0 (no disgreement) Introduction Methods Results and Discussion Results and Discussion Conclusion References

19. 19 Introduction Methods Results and Discussion Results and Discussion Conclusion References

20. 20 Question 4 – NRS vs VAS Comunico com amigos/familiares frequentemente pela Internet Question 5 – VNS vs NRS Acedo frequentemente a informação diária na Internet Question 6 – VAS vs VNS Acedo frequentemente a motores de busca para pesquisa de informação [ -5,21 ; 5,56 ] [ -4,65 ; 4,51 ] [ -3,03 ; 3,20 ] Numeric Rating Scale Visual Numeric Scale Discordo totalmente Concordo totalmente 1 2 3 4 5 6 7 8 9 10 Visual Analogue Scale Discordo totalmente Concordo totalmente

21. 21 ScalesNIBMD (95% CI) NRS vs VAS1300,28 [0,24 ; 0,33] VNS vs NRS1270,31 [0,27; 0,36] VAS vs VNS1300,15 [0,13 ; 0,18] Information based measure of disagreement (IBMD) IBMD=0 (no disgreement) Introduction Methods Results and Discussion Results and Discussion Conclusion References

22. Introduction Methods Results and Discussion Conclusion Conclusion References 22 All the scales had an identical low reproducibility VAS and VNS are the most accordable scales, dispite of the accordance are very low

23. Introduction Methods Results and Discussion Conclusion References References 23 Bousquet, P.J., et al., Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines. Allergy, 2007. 62(4): p. 367-372. Choi, B.C. and A.W. Pak, A catalog of biases in questionnaires. Prev Chronic Dis, 2005. 2(1): p. A13. Hartman, J.M., et al., Tutorials in clinical research: part IV: recognizing and controlling bias. Laryngoscope, 2002. 112(1): p. 23-31. Hogikyan, N.D. and C.A. Rosen, A review of outcome measurements for voice disorders. Otolaryngol Head Neck Surg, 2002. 126(5): p. 562-72. Pesudovs, K., et al., The development, assessment, and selection of questionnaires. Optometry and Vision Science, 2007. 84(8): p. 663-674. Pires, M.D., G. Oliveira, and M. Behlau, Voice Activity and Participation Profile - VAPP administered in two different scales of response. J Soc Bras Fonoaudiol, 2011. 23(3): p. 297-300. Price, D.D., et al., A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain, 1994. 56(2): p. 217-26. Rouve, S., et al., Numeric score and visual analog scale in assessing seasonal allergic rhinitis severity. Rhinology, 2010. 48(3): p. 285-91. Schiavetti, N., et al., Direct magnitude estimation and interval scaling of stuttering severity. J Speech Hear Res, 1983. 26(4): p. 568-73.

24. Introduction Methods Results and Discussion Conclusion References References 24 Professor Altamiro Pereira Teachers Cristina Santos e Gustavo Bacelar Mr. Bruno Neves and Mrs. Marta Moreira All the participants in the study

25. Introduction to Medicine II Class 6 Regent Teacher: Altamiro Pereira Supervisor Teachers: Cristina Santos e Gustavo Bacelar