Methodological issues in community-based studies of gynecological morbidity.

This report describes the lessons learned from a series of community-based studies of gynecological morbidity among young married women in Karnataka State, India. Women's self-reports of symptoms of illness were found to be responsive to the context of the interview and the nature of questioning. In particular, women appeared much readier to report symptoms to lay interviewers after being invited to undergo a clinical examination in the near future than they were if no examination were offered. Little consistency was found in the results obtained from interviews, clinical examinations, and laboratory tests. Apparently, no alternative exists to the collection of biological specimens for laboratory analysis when estimates of disease prevalence are needed. Use of generic health-related quality-of-life assessments is recommended for future surveys. Prospective studies will yield more valuable data on these topics than will cross-sectional surveys.