Validation of the Oxford WebQ online 24-hour dietary questionnaire using biomarkers

DC Greenwood, LJ Hardie, GS Frost, NA Alwan, KE Bradbury, Michelle Carter, Paul Elliott, CEL Evans, HE Ford, N Hancock, TJ Key, Bette Liu, MA Morris, UZ Mulla, K Petropoulou, GDM Potter, E Riboli, Heather Young, PA Wark, JE Cade

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    The Oxford WebQ is an online 24-hour dietary questionnaire that is appropriate for repeated administration in large-scale prospective studies, including the UK Biobank study and the Million Women Study. We compared the performance of the Oxford WebQ and a traditional interviewer-administered multiple-pass 24-hour dietary recall against biomarkers for protein, potassium, and total sugar intake and total energy expenditure estimated by accelerometry. We recruited 160 participants in London, United Kingdom, between 2014 and 2016 and measured their biomarker levels at 3 nonconsecutive time points. The measurement error model simultaneously compared all 3 methods. Attenuation factors for protein, potassium, total sugar, and total energy intakes estimated as the mean of 2 applications of the Oxford WebQ were 0.37, 0.42, 0.45, and 0.31, respectively, with performance improving incrementally for the mean of more measures. Correlation between the mean value from 2 Oxford WebQs and estimated true intakes, reflecting attenuation when intake is categorized or ranked, was 0.47, 0.39, 0.40, and 0.38, respectively, also improving with repeated administration. These correlations were similar to those of the more administratively burdensome interviewer-based recall. Using objective biomarkers as the standard, the Oxford WebQ performs well across key nutrients in comparison with more administratively burdensome interviewer-based 24-hour recalls. Attenuation improves when the average value is taken over repeated administrations, reducing measurement error bias in assessment of diet-disease associations.

    Original languageEnglish
    Pages (from-to)1858-1867
    Number of pages10
    JournalAmerican Journal of Epidemiology
    Issue number10
    Early online date18 Jul 2019
    Publication statusPublished - 1 Oct 2019

    Bibliographical note

    Author notes: Darren C. Greenwood, Laura J. Hardie, and Gary S. Frost contributed equally as joint first authors; Petra A. Wark and Janet E. Cade contributed equally as joint senior authors.


    Medical Research Council (UK) grant MRC G1100235


    • Million Women Study
    • UK Biobank
    • diet questionnaires
    • dietary assessment
    • nutrition assessment
    • recall
    • recovery biomarkers
    • validation

    ASJC Scopus subject areas

    • Epidemiology


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