Validity of self-reported mechanical demands for occupational epidemiologic research of musculoskeletal disorders

Abstract

Objectives: To describe the relation of the measured validity of self-reported mechanical demands (self-reports) with the quality of validity assessments and the variability of the assessed exposure in the study population.

Methods: We searched for original articles, published between 1990 and 2008, reporting the validity of self-reports in three major databases: EBSCOhost, Web of Science and PubMed. Identified assessments were classified by methodological characteristics (eg, type of self-report and reference method) and exposure dimension was measured. We also classified assessments by the degree of comparability between the self-report and the employed reference method, and the variability of the assessed exposure in the study population. Finally, we examined the association of the published validity (r) with this degree of comparability, as well as with the variability of the exposure variable in the study population.

Results: Of the 490 assessments identified, 75% used observation-based reference measures and 55% tested self-reports of posture duration and movement frequency. Frequently, validity studies did not report demographic information (eg, education, age, and gender distribution). Among assessments reporting correlations as measure of validity, studies with a better match between the self-report and the reference method, and studies conducted in more heterogeneous populations tended to report higher correlations [odds ratio (OR) 2.03, 95% confidence interval (95% CI) 0.89-4.65 and OR 1.60, 95% CI 0.96-2.61, respectively].

Conclusions: The reported data support the hypothesis that validity depends on study-specific factors often not examined. Experimentally manipulating the testing setting could lead to a better understanding of the capabilities and limitations of self-reported information.

Figure 1

An example of the process whereby questions are classified according to the exposure dimension being assessed. The underlined part of the question is the focus of the question. The predicate refers to the remaining part of the question. The response scale is presented in italics. In the upper box, there is an example of a question on the frequency, duration, and magnitude of the exposure. In the middle box, there is an example of a question on the duration and magnitude of the exposure. In the lower box, there is an example of a question on only the magnitude of the exposure.

Figure 2

Manuscript search, identification, and selection process.

Figure 3

Distribution of validity assessments by exposure and reference method employed (N=490 validity assessments). As an example: of all validity tested self-reports evaluating the posture exposure category, 75.4% were tested against observation methods, 16.7% were tested against direct measurement methods, and 7.7% were tested against other self-reports. (Movem = movement, Repet = repetition, Phys. = physical)

Figure 4

Distribution of validity assessments by exposure and exposure dimension assessed (N=490 validity assessments). As an example: 32% of all validity tested self-reports evaluated the posture exposure category; 81% of these self-reports evaluated simultaneously the duration and magnitude dimensions of the posture. (Movem = movement, Repet = repetition, Phys. = physical)