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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #294405
Title: Reliability and validity of a modified Bristol Stool Form Scale for children

Author
item LANE, MARIELLA - Baylor College Of Medicine
item CZYZEWSKI, DANITA - Baylor College Of Medicine
item CHUMPITAZ, BRUNO - Texas Children'S Hospital
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal of Pediatrics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/1/2011
Publication Date: 9/1/2011
Citation: Lane, M.M., Czyzewski, D.I., Chumpitaz, B.P., Shulman, R.J. 2011. Reliability and validity of a modified Bristol Stool Form Scale for children. Journal of Pediatrics. 159(3):437-441.

Interpretive Summary: Stooling problems are very common in children. Many factors such as diet can affect the stooling pattern. However, up until now, there has been no way to accurately assess a child's stooling pattern. In this study we developed and validated a chart that allows even young children to accurately describe their stooling pattern. This tool can be utilized by the pediatric community in addressing stooling problems.

Technical Abstract: This study sought to: evaluate the ability of children to reliably use a modified Bristol Stool Form Scale for Children (mBSFS-C), evaluate criterion-related validity of the mBSFS-C, and identify the lower age limit for mBSFS-C use. The mBSFS-C comprises 5 stool form types described and depicted in drawings. Children 3 to 18 years old rated stool form for 10 stool photographs. Because of low reliability when stool form descriptors were not read aloud (n = 119), a subsequent sample of children (n = 191) rated photographs with descriptors read. Intraclass correlation coefficients for descriptor-unread versus -read samples were 0.62 and 0.79, respectively. Children were increasingly reliable with age. Percentage of correct ratings varied with stool form type, but generally increased with age. With descriptors unread, children 8 years and older demonstrated acceptable interobserver reliability, with >78% of ratings correct. With descriptors read, children 6 years and older demonstrated acceptable reliability, with >80% of ratings correct. The mBSFS-C is reliable and valid for use by children, with age 6 years being the lower limit for scale use with descriptors read and age 8 years being the lower limit without descriptors read. We anticipate that the mBSFS-C can be effectively used in pediatric clinical and research settings.