Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations.
Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations.
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DOI：
10.1111/nmo.12738
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发表时间：
2016-03
影响因子：
3.5
通讯作者：
Shulman RJ
中科院分区：
文献类型：
--
作者：
Chumpitazi BP;Self MM;Czyzewski DI;Cejka S;Swank PR;Shulman RJ
布里斯托尔粪便形态量表(BSFS)将粪便分为七种类型之一，评分员的可重复性尚不清楚。我们试图通过个体大便类型以及罗马III临床名称将反应归类为正常或异常(便秘或腹泻)来确定可靠性和一致性。来自三个机构的34名胃肠病提供者使用BSFS对35张大便照片进行了评级。有20个人转发了这些照片。完成了1190个人的粪便类型评级。虽然只有4张照片有绝对的一致性(都是类型1或类型7)，但总体一致性很高，有1132张(95.1%)的评级在一个类别的模式评级范围内。BSFS的评分者间信度和评分者内信度分别为0.88(95%CI：0.86-0.9)和0.89(95%CI：0.86-0.91，P<；0.001)。然而，当使用罗马III命名时，一致性降低，13张(37%)照片的分类明显不同(半四分位数范围=0.5)。这13张照片被大多数评分者评为类型2与类型3或类型5与类型6，代表了正常与不正常大便的界限。罗马III临床分类评分员间和评分员内信度降低，组内相关系数分别为0.75(95%CI：0.69-0.81，P<；0.001)和0.65(95%CI：0.49-0.81，P<；0.001)。BSFS用于评分者对个体大便类型进行评分时，具有很好的可靠性和一致性。然而，在确定罗马III粪便类型时，BSFS的可靠性和一致性会降低。
Rater reproducibility of the Bristol Stool Form Scale (BSFS), which categorizes stools into one of seven types, is unknown. We sought to determine reliability and agreement by individual stool type and when responses are categorized by Rome III clinical designation as normal or abnormal (constipation or diarrhea). Thirty-four gastroenterology providers from three institutions rated 35 stool photographs using the BSFS. Twenty rerated the photographs. 1190 individual stool type ratings were completed. Though only 4 photographs had absolute agreement (all Type 1 or Type 7), general agreement was high with 1132 (95.1%) of ratings being within one category type of the modal rating. Inter-rater and intra-rater reliability of the BSFS by individual stool type was excellent with intraclass correlations of 0.88 (95% CI: 0.86–0.90), P<0.001) and 0.89 (95% CI: 0.86–0.91, P<0.001) respectively. However, agreement decreased when using Rome III designations, with 13 (37%) photographs having significantly diverging classifications (semi-interquartile range=0.5). These 13 photographs were rated by the majority of raters as either type 2 vs. type 3 or type 5 vs. type 6 stools, representing the boundaries of normal vs. abnormal stools. Inter-rater and intra-rater reliability of the BSFS by Rome III clinical categorization decreased with intraclass correlations of 0.75 (95% CI: 0.69 – 0.81, P<0.001) and 0.65 (95% CI: 0.49 – 0.81, P<0.001) respectively. BSFS has excellent reliability and agreement when used to rate individual stool type by raters. However, BSFS reliability and agreement decreases when determining Rome III stool form categories.