The Validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for Evaluating Symptoms in the Clinical Setting

Abstract

The SAGIS instrument has excellent psychometric properties and supports the clinical assessment of and symptom-based categorization of patients with a wide spectrum of gastrointestinal symptoms.

Inconsistent symptom clusters for functional gastrointestinal disorders in Asia: is Rome burning?

“…Indeed, some structured assessments of symptoms include items to identify the ‘most’ important symptom10 and would allow in a very simple way to identify the symptom that is of greatest relevance for the patient. However, applying such an approach rather than Rome-based groupings would need to be prospectively and rigorously tested to determine if this allows the identification of robust pathophysiological abnormalities and (more importantly) predicts responses to therapy.…”

“…While the authors conclude in their paper that the ‘…broad categorisation used both in clinical practice and in the Rome system,…’ ‘…are still valid…’ a closer analysis suggests that the groupings are actually different with a substantially smaller number of categories. Similarly, a new questionnaire designed to capture the broad spectrum of GI symptoms in routine clinical settings10 revealed five distinct symptom clusters: namely (A) dyspepsia symptoms (including early satiety, postprandial pain, epigastric pain, retrosternal pain); (B) reflux symptoms (including acid eructation, dysphagia, belching);  (C) nausea/vomiting; (D) diarrhoea and incontinence (including defecation-related discomfort/pain); and (E) constipation. Clearly, it appears symptom clusters observed in the Asian9 and Australian10 patient populations differ from the categories proposed by Rome III and included in the recent Rome IV criteria (table 1).…”

“…Recently, however, a novel instrument (Structured Assessment of GI Symptoms10) was validated in a mixed Caucasian/Asian population within a routine clinical setting. This revealed a factor structure that essentially mirrored the factor structure described by Siah et al 9.…”

Patient-Reported Outcome Measures in Routine Clinical Care: The PROMise of a Better Future?

“…In this issue of Digestive Diseases and Sciences, Koloski et al [7] report on the development and validation of a new PROM-the Gastrointestinal Symptoms Scale (SAGIS) which they hope can be used routinely to support the standardized clinical assessment of patient symptoms with a wide range of gastrointestinal conditions. The authors justify the need for this tool particularly with gastrointestinal patients due to the range of patient symptoms, the potential for bias in the clinical assessment, and the time required to collect this information during the clinical consultation.…”

“…They also recommend that ideally the same PROM should be used in clinical practice and trials to avoid the current disconnect when interpreting the results of clinical trials and translating them into routine clinical practice [10]. Koloski et al [7] have gone some way toward achieving this goal, and their SAGIS tool shows the initial promise. Nevertheless, it remains to be seen whether the challenges associated with routine PROM collection can be overcome in order to allow the successful integration of the SAGIS into clinical practice so as to better manage patients with gastrointestinal disorders.…”