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Are abdominal x-rays a reliable way to assess for constipation?

Susan Moylan1, Jennifer Armstrong, Dawn Diaz-Saldano

  • 1Division of Urology, Children's Memorial Hospital, Chicago, Illinois 60614, USA.

The Journal of Urology
|August 24, 2010
PubMed

Insights

Existing X-ray scoring tools for pediatric constipation lack reliability. Further research is needed to develop a dependable method for assessing constipation in children using abdominal X-rays.

Area of Science:

  • Pediatric gastroenterology
  • Radiology
  • Clinical assessment tools

Background:

  • Constipation is a common pediatric issue.
  • Abdominal X-rays are frequently used in clinical practice for evaluating lower urinary tract symptoms.
  • Validated tools for assessing constipation in children via X-ray are currently lacking.

Purpose of the Study:

  • To assess the reliability of three existing X-ray scoring tools (Barr, Leech, Blethyn) for evaluating constipation in children.
  • To determine if these tools provide consistent results among multiple practitioners.

Main Methods:

  • Retrospective analysis of abdominal X-rays from 80 children (ages 4-12).
  • Independent assessment of X-rays by practitioners using Barr, Leech, and Blethyn scoring tools.
  • Reliability analysis using weighted kappa (κ) scores and intraclass correlation coefficients (ICC).

Main Results:

  • Weighted κ scores ranged from 0.0454 to 0.4809, indicating marginal to good reproducibility.
  • ICC values ranged from 0.02577 to 0.3313, indicating poor to good reliability.
  • A trend towards good interrater reliability was observed with the Barr and Blethyn tools among experienced urology practitioners, but not with the Leech tool or less experienced raters.

Conclusions:

  • Currently available X-ray scoring tools demonstrate inadequate reliability for assessing pediatric constipation across multiple examiners.
  • Development of a new, more reliable X-ray assessment tool for pediatric constipation is necessary.
Abstract

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