Gastrointestinal recall questionnaires compare poorly with prospective patient diaries for gastrointestinal symptoms: data from population and primary health centre samples

Abstract

Background Clinical understanding of gastrointestinal symptoms is commonly based on patient reports of symptom experience. For diagnosis and treatment choices to be appropriate, symptom reports need to be accurate. We examined the agreement between questionnaire recall and prospective diary enumeration of symptoms relevant to the irritable bowel syndrome. Patients and methods Data are reported from a randomly selected general population sample (n=238) and also a primary healthcare centre (PHC) sample (n=503, 10 PHCs). All the patients completed the questionnaires, which included Rome III-qualifying irritable bowel syndrome items and a stool and symptom diary over either 7 or 14 days. Agreement between retrospective questionnaire reports and prospective diaries was evaluated. Results Concordance between questionnaires and diaries was highest for the simple construct of the occurrence of abdominal pain, although after adjusting for possible chance, agreement was only moderate in the general population sample. More complex constructs, such as pain relieved by defecation, yielded poorer concordance. In general, concordance was stronger among PHC respondents than in the general population sample. Conclusion Concordance between questionnaires and diaries was generally poor and related to the complexity of the symptom construct and the type of respondent. The information used to classify individuals based on patient self-report may be unreliable, and therefore, more effort is needed to develop data collection instruments.

Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis

“…Twelve studies approximated the Rome III criteria using another questionnaire, with a pooled prevalence of 14.0% (95% CI 11.2% to 17.0%). 20,28,30,32,36,50,62,[68][69][70][71]77 Five of the six studies reported prevalence of IBS according to the Rome IV criteria using the validated questionnaire, with a pooled prevalence of 3.6% (95% CI 3.0% to 4.3%). 55,72,76,78,79 The sixth study approximated Rome IV criteria using another questionnaire, 73 with a prevalence of 10.4% (95% CI 8.2% to 12.1%).…”

“…When studies were pooled according to the method of administration of the questionnaire, again there were significant differences in prevalence between individual studies. When the Rome III questionnaire was administered at an interview in 29 studies, 20,22,23,31,[33][34][35]37,[39][40][41][42][45][46][47][48][49][51][52][53]60,61,[65][66][67]69,70,75,79 the prevalence of IBS ranged from 0.4% in India and Ghana, 79 to 20.9% in Singapore, 61 with a pooled prevalence of 5.9% (95% CI 4.6% to 7.4%). When the same questionnaire was self-completed in 22 studies 24,28-30,32,36,38,43,44,50,54,56,58,59,62-64,68,71,77-79 the prevalence ranged from 2.0% in the USA, 58 to 29.2% in Croatia, 24 with a pooled prevalence of 12.0% (95% CI 9.6% to 14.6%).…”

Digital Health Apps in the Clinical Care of Inflammatory Bowel Disease: Scoping Review

“…One study observed that health care providers frequently misinterpret reported symptoms, leading to differences in how the patient and the physician perceive a patient’s current state [68]. As a further challenge, the concordance between a patient’s memory of experience and actual experience of gastrointestinal (GI) symptoms has been observed to be generally poor [69]. The insufficient identification and management of IBD flares is one reason that many patients have poor outcomes [49].…”

Effect of Definitions of Acute Gastroenteritis Episodes Using Symptom Diaries in Paediatric Cohorts

“…Ideally, data should be collected prospectively to reduce recall error. However, if collected retrospectively to reduce participant burden in cohort studies or for obtaining point-prevalence data from cross-sectional surveys, the length of the recall time-period should be limited preferably to 1 week (5). When calculating AGE incidence, both the AGE episode itself and the minimum length of time separating what would be considered two consecutive episodes (the refractory period) need to be defined (6).…”