ASKING QUESTIONS ABOUT WOMENS REPRODUCTIVE HEALTH - VALIDITY AND RELIABILITY OF SURVEY FINDINGS FROM ISTANBUL

In countries where population-based data on health problems are scarce , the extent of reproductive morbidity can be estimated from replies i n structured interviews as a complement or as an alternative to report s from physician's examination and laboratory tests. We examined the s ensitivity and specificity of detected morbidity based on these replie s as compared to medical diagnoses and explored the consistency of rep lies when the questionnaire was administered twice, by two types of in terviewers in different environments. Data were collected in a cross-s ectional survey in Istanbul. The presence or absence of five morbiditi es, reproductive and urinary tract infections (RTI and UTI), menstrual disorders, pelvic relaxation and anaemia was determined by algorithms based on the replies, and by the physician's diagnosis. Except with a naemia, questionnaire replies were more specific than sensitive in det ecting morbidity, probably partly due to many morbid conditions being accepted as normal. Specificity exceeded 80% for home reports of menst rual disorders (93.0%), pelvic relaxation (95.7%), RTI (abnormal disch arge and pain) (81.2%) and UTI (80.7%), with the corresponding figure for anaemia at 41.7%; the best sensitivity results were for anaemia (5 8.3%), RTI (abnormal discharge only) (49.3%) and menstrual disorders ( 45.4%) with figures for pelvic relaxation and UTI reaching only 17.3 a nd 13.0% Reliability between the interviews (assessed by the kappa coe fficient), was highest at 66.1% for pelvic relaxation and lowest at 39 .9% for menstrual disorders. Reliability varied between the two lay in terviewers, suggesting the interviewer and the interview conditions ar e important. Questionnaire-based information on this type of morbidity is most useful for ascertaining perceived ill-health and only of limi ted use for the corresponding medically defined conditions.