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Research Project: Pediatric Clinical Nutrition

Location: Children's Nutrition Research Center

Title: Agreement between prospective diary data and retrospective questionnaire report of abdominal pain and stooling symptoms in children with irritable bowel syndrome

item SELF, M - Baylor College Of Medicine
item WILLIAMS, A - Indiana University School Of Medicine
item CZYZEWSKI, D - Baylor College Of Medicine
item WEIDLER, E - Children'S Nutrition Research Center (CNRC)
item SHULMAN, R - Children'S Nutrition Research Center (CNRC)

Submitted to: Neurogastroenterology & Motility
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/17/2015
Publication Date: 8/1/2015
Citation: Self, M.M., Williams, A.E., Czyzewski, D.I., Weidler, E.M., Shulman, R.J. 2015. Agreement between prospective diary data and retrospective questionnaire report of abdominal pain and stooling symptoms in children with irritable bowel syndrome. Neurogastroenterology & Motility. 27(8):1110-1119.

Interpretive Summary: Questionnaires are used commonly to find out what gastrointestinal symptoms patients are having and what foods they are eating. Their answers often determine what treatments they will receive and how they respond to treatments. However, to answer a questionnaire, patients have to remember. Another option is to have patients keep a diary. This study compared the results of a questionnaire about children's symptoms completed by the child and the parent with a daily diary kept by the child. Our results showed that a child answering a questionnaire can be useful if the child is asked to remember just a short interval but that a diary is the most accurate way to find out what gastrointestinal symptoms are present. This data and existing literature is supportive of using a diary data in the future.

Technical Abstract: In functional gastrointestinal disorders, patient recall of symptoms drives diagnostic decisions and evaluation of treatment response, and research conclusions about potential treatments. In pediatrics, parent report also impacts assessment and care. Hence, identifying methods for accurately capturing patient and parent report of irritable bowel syndrome (IBS) symptoms is important. This study evaluated correspondence between retrospective questionnaire (parent and child report) and prospective diary data for children and adolescents with IBS. Participants included 50 children/adolescents with IBS per Rome III criteria. Children completed a 2-week pain and stool diary. Children and parents subsequently completed a 2-week recall questionnaire, reporting number of pain days, maximum pain, days without bowel movement, and days with diarrhea during the diary interval. Intraclass correlation coefficients and Bland-Altman plots assessed agreement. For pain and days without bowel movement, overall agreement between child recall questionnaire and child diary was strong, although under conditions likely to facilitate agreement and with individual variation observed. Parent recall and child diary were less concordant, and agreement about diarrhea was poor for parent and child. Age did not significantly correlate with agreement. Child questionnaire with short recall interval may be a reasonable approximation for diary data, although this varies by individual and replication/investigation of lengthier recall are needed. Relying on parent questionnaire does not appear a suitable proxy, and recall of stool form by both parent and child appears more problematic. These results combined with existing literature support use of diary data whenever possible.