st: How to analyze paired ordinal data (before and after disease) with Stata

[Fredrik Norström <fredrik.norstrom@epiph.umu.se>]

Dear all,

I have observed frequency of symptoms, i.e. headache, before and after diagnosis with 5 response alternatives from "never" to "always". I want to test if things have significantly improved after diagnosis. Going through the literature I notice that very few tests are suited for matched ordinal data.

I have looked at the Stata command "Symmetry" and the options for it. My judgment from the limited help file is that options within symmetry only tests symmetry and not the direction of the change. My interest is not to test if responders changed their state which is the case for e.g. Stuart-Maxwell.

Is there any function in Stata that actually tests ordinal paired data for improvement in states? If not can anyone recommend literature or test within other software so that I can test my data without using Stata? My best solution at the moment is to dichomotize my data and then it is not difficult to find a suitable test but feels like a waste to not use my data to its full extent.

Any suggestion is very much appreciated.

Fredrik

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