title: Validity and reliability of parental report of frequency, severity and risk factors of urinary tract infection and urinary incontinence in children.
abstract: OBJECTIVE
  We describe the validity and reliability of a questionnaire designed to determine frequency, severity and risk factors of urinary tract infection and daytime urinary incontinence in primary school-age children.
  
  
  METHODS
  Based on published validated questionnaires and advice from content experts, a questionnaire was developed and piloted in children attending outpatient clinics. Construct validity for parent report of frequency and severity of daytime urinary incontinence was tested by comparison with a daily accident diary in 52 primary school children, and criterion validity of parent report for UTI was verified by comparison with the reference standard (urine culture) in 100 primary school children. Test-retest reliability of the questionnaire was assessed in 106 children from primary schools.
  
  
  RESULTS
  There was excellent agreement between the questionnaire and accident diary in severity (weighted kappa 0.94, 95% confidence intervals 0.85 to 1.03) and frequency of daytime urinary incontinence (0.88, 0.7 to 1.0). Parents reported urinary tract infection in 15% of children, compared to a positive urine culture in 8% (sensitivity 100% and specificity 68.5%). Test-retest reliability of the questionnaire was excellent (mean k 0.78, range 0.61 to 1.00).
  
  
  CONCLUSIONS
  Parents overreport UTI by about 2-fold but can recall frequency and severity of daytime urinary incontinence well during a 3-month period. The developed questionnaire is a valid tool to estimate frequency, severity and risk factors of daytime urinary incontinence and UTI in primary school children.
authors.affiliation: Centre for Kidney Research, NHMRC Centre for Clinical Research Excellence, Children's Hospital at Westmead, Sydney, Australia. premalas@wch.edu.au
authors.forename: Premala
authors.initials: P
authors.lastname: Sureshkumar
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D010290:Parents; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology