Does Crosswise Method Cause Overestimation? An Example to Estimate the Frequency of Symptoms Associated With Sexually Transmitted Infections in General Population: A Cross Sectional Study

Abstract

Background: Crosswise, as an indirect questioning method, is not applied to the general population. The current study aimed at assessing the feasibility of crosswise among Iranian general population to estimate the frequency of sexually transmitted infection (STI) symptoms. Methods: To estimate the frequency of STI-associated symptoms among the general population of Kerman, Iran, in 2014, participants were inquired to specify whether their "yes or no" answers to a set of paired questions (sensitive/non-sensitive) were the same (concordance) or different (discordance). Based on the frequency of concordance response and known prevalence of positive response to non-sensitive questions, the frequency of positive responses to the sensitive questions was estimated. The estimations were compared with the results of a population-based survey, conducted at the same time and setting, in which participants directly responded to the sensitive questions. Results: The current study recruited 128 people aged 18 -60 years (50% male). The estimated frequency for genital ulcer in crosswise method was 53.1% and 34.9% in males and females, respectively. The estimated frequency of urethral discharge in crosswise method was 72.3%. The crosswise method outcomes were significantly different from those of the survey (P > 0.05). Conclusions:The estimated frequency of STI-associated symptoms in crosswise was unexpectedly higher than that of obtained by the population-based survey. Hence, experts in the field of STIs did not accept the crosswise estimations. This overestimation could be a result of differences in the ability of people, with various socioeconomic levels, to understand conceptually how to answer the questions along with the influence of study setting and administration method of questionnaires on the participants self-reports.

Functionality of the Crosswise Model for Assessing Sensitive or Transgressive Behavior: A Systematic Review and Meta-Analysis

“…We conducted a systematic review and meta-analysis as well as quality assessment of empirical applications of CM Coutts et al, 2011;Jann et al, 2012;Korndörfer et al, 2014;Hoffmann et al, 2015Hoffmann et al, , 2017Höglinger et al, 2016;Kundt et al, 2017;Heck et al, 2018;Nasirian et al, 2018;Hopp and Speil, 2019;Lehrer et al, 2019;Safiri et al, 2019;Schnapp, 2019;Walzenbach and Hinz, 2019;Meisters et al, 2020b;Özgül, 2020Özgül, k = 7 Kundt, 2014Höglinger and Diekmann, 2017;Höglinger and Jann, 2018;Atsusaka and Stevenson, 2020;Hoffmann et al, 2020;Meisters et al, 2020a;Jerke et al, 2021 CM prevalence (k =18) Nakhaee et al, 2013;Kazemzadeh et al, 2016k = 9 Eslami et al, 2013Waubert de Puiseau et al, 2017;Banayejeddi et al, 2019;Klimas et al, 2019;Vakilian et al, 2019;Jensen, 2020;Lacker et al, 2020;Mieth et al, 2021k = 7 Shamsipour et al, 2014Vakilian et al, 2014Vakilian et al, , 2016Gingerich et al, 2015;…”

“…Sixteen studies employed non-birthday innocuous items (Kundt, 2014;Shamsipour et al, 2014;Vakilian et al, 2014Vakilian et al, , 2016Vakilian et al, , 2019Khosravi et al, 2015;Kundt et al, 2017;Mirzazadeh et al, 2018;Nasirian et al, 2018;Banayejeddi et al, 2019;Hopp and Speil, 2019;Lehrer et al, 2019;Safiri et al, 2019;Schnapp, 2019;Atsusaka and Stevenson, 2020;Jerke et al, 2021) totaling 46 item pairs. In addition, seven studies (Shamsipour et al, 2014;Khosravi et al, 2015;Nasirian et al, 2018;Banayejeddi et al, 2019;Hopp and Speil, 2019;Safiri et al, 2019;Schnapp, 2019) used a combination of birthday and non-birthday innocuous item pairs. Phone numbers were used in seven studies (Shamsipour et al, 2014;Khosravi et al, 2015;Vakilian et al, 2016Vakilian et al, , 2019Kundt et al, 2017;Banayejeddi et al, 2019;Safiri et al, 2019), house numbers in seven studies (Kundt, 2014;Shamsipour et al, 2014;Khosravi et al, 2015;Lehrer et al, 2019;Safiri et al, 2019;Schnapp, 2019;Vakilian et al, 2019), ATM card pin code in three studies (Sham...…”

“…Of these, 49 pairs used specific birthday months with P ranging between 0.08 (1/12 months) and 0.25 (3/12 months). In five cases (Eslami et al, 2013;Nakhaee et al, 2013;Khosravi et al, 2015;Nasirian et al, 2018;Safiri et al, 2019), season (e.g., spring) was used which is open for interpretation Substance use and misuse Nakhaee et al, 2013;Shamsipour et al, 2014;Höglinger et al, 2016;Mirzazadeh et al, 2018;Banayejeddi et al, 2019;Safiri et al, 2019;Özgül, 2020;Canan et al, 2021Shamsipour et al, 2014Mirzazadeh et al, 2018;Safiri et al, 2019 Academic misconduct Coutts et al, 2011;Jann et al, 2012;Höglinger et al, 2016;Hopp and Speil, 2019;Jerke et al, 2021Coutts et al, 2011Jann et al, 2012;Jerke et al, 2021 Corruption, tax evasion, and theft Korndörfer et al, 2014;Kundt, 2014;Gingerich et al, 2015;Höglinger and Jann, 2018;Hopp and Speil, 2019;Oliveros and Gingerich, 2020 Health and STDs Mirzazadeh et al, 2018;Nasirian et al, 2018 Sexual behavior and infidelity Mirzazadeh et al, 2018;Klimas et al, 2019;Lacker et al, 2020 Substance use and misuse Khosravi et al, 2015;Kazemzadeh et al, 2016;Heck et al, 2018;…”

“…For studies employing items with uncertain probabilities such as name of friend or relative (Vakilian et al, 2014(Vakilian et al, , 2019, number of main family members and owning a vehicle (Nasirian et al, 2018), conference attendance and research proposal writing (Jerke et al, 2021), authors relied on population statistics for probabilities. The probability of a "yes" answer for the innocuous items in these studies ranged from P = 0.08 to P = 0.7, with P = 0.33 being most frequent.…”

“…Online questionnaires (k = 21) Korndörfer et al, 2014;Kundt, 2014;Hoffmann et al, 2015Hoffmann et al, , 2017Höglinger et al, 2016;Höglinger and Diekmann, 2017;Waubert de Puiseau et al, 2017;Höglinger and Jann, 2018;Hopp and Speil, 2019;Klimas et al, 2019;Lehrer et al, 2019;Schnapp, 2019;Walzenbach and Hinz, 2019;Atsusaka and Stevenson, 2020;Jensen, 2020;Lacker et al, 2020;Meisters et al, 2020a;Canan et al, 2021;Jerke et al, 2021;Mieth et al, 2021 Paper questionnaires (k = 18) Coutts et al, 2011;Jann et al, 2012;Nakhaee et al, 2013;Shamsipour et al, 2014;Vakilian et al, 2014Vakilian et al, , 2016Vakilian et al, , 2019Khosravi et al, 2015;Kazemzadeh et al, 2016;Heck et al, 2018;Mirzazadeh et al, 2018;Nasirian et al, 2018;Banayejeddi et al, 2019;Safiri et al, 2019;Hoffmann et al, 2020;Meisters et al, 2020b;Özgül, 2020 Interviews (k = 4) Gingerich et al, 2015;Kundt et al, 2017;Oliveros and Gingerich, 2020 Interviews and questionnaires (k = 2) Eslami et al, 2013;Jerke e...…”