CONSENSUS ANALYSIS - RELIABILITY, VALIDITY, AND INFORMANT ACCURACY INUSE OF AMERICAN AND MANDARIN CHINESE PAIN DESCRIPTORS

A quantitative method for validating quantitative interview results an d checking sample parameters is described and illustrated using common pain descriptions among a sample of Anglo-American and mandarin Chine se patients and dentists matched by age and gender: Assumptions were t hat subjects,were members of a sociocultural group (e.g. ethnic or pro fessional/lay) and answered questions independently about a monotonic domain (e.g. pain). Subjects answered 18 true/false items derived from and selected to reflect pain perceptions consistent with published an d unpublished interview data. Estimates of consistency in use of descr iptors within groups, validity of description, accuracy of individuals compared with others in their group, and minimum required sample size were calculated using Cronbach's alpha factor analysis, and Bayesian probability Ethnic and professional differences within and across grou ps were also tested using multidimensional scaling (MDS) and hypothesi s testing. Consensus (consistency of subject response by group) was .9 9 among Anglo-American and .97 among Chinese. Mean subject accuracy wa s .81 for Americans and .57 for Chinese, indicating the need for large r numbers of Chinese to supplement each others' statements. However la rger numbers of subjects were recruited than actually required for eac h ethnic group at .95 confidence limits. MDS showed similarities in us e of descriptors within ethnic groups, while there were differences (p <.001) between Chinese mid American groups. Use of covalidating quest ionnaires that reflect results of qualitative interviews are recommend ed in order to estimate sample parameters such as intersubject agreeme nt, individual subject accuracy, and minimum required sample sizes.