Related Experiment Video
Updated: Jun 9, 2026
Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Creation and initial evaluation of a Stool Form Scale for children
Bruno P Chumpitazi1, Mariella M Lane, Danita I Czyzewski
1Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, University of Texas Health Science Center-Houston, Houston, TX 77030, USA. bpchumpi@texaschildrens.org
Insights
A new pediatric stool scale, based on the Bristol Stool Form Scale, shows high reliability and agreement among pediatric gastroenterologists for assessing stool form in children.
Area of Science:
- Pediatric Gastroenterology
- Clinical Assessment Tools
Background:
- Accurate assessment of stool form is crucial in pediatric gastroenterology.
- Existing tools may require adaptation for pediatric populations.
Purpose of the Study:
- To develop a pediatric stool form rating scale.
- To evaluate its interrater and intrarater reliability and agreement among specialists.
Main Methods:
- Modified Bristol Stool Form Scale with 5 categories developed.
- 14 pediatric gastroenterologists rated 32 stool photographs.
- 10 raters reassessed photographs after 6 months.
Main Results:
- 94% of ratings were within one category of the modal rating.
- High interrater reliability (ICC=0.85) and intrarater reliability (ICC=0.87) observed.
- Complete agreement among all raters for 25% of stool photographs.
Conclusions:
- The modified pediatric Bristol Stool Form Scale demonstrates excellent reliability and agreement.
- This scale is a valuable tool for standardizing stool form assessment in children.
Objective:
To develop a pediatric stool form rating scale and determine its interrater reliability, intrarater reliability, and agreement among pediatric gastroenterologists.
Study Design:
An ordinal stool scale with 5 categorical stool form types was created on the basis of the Bristol Stool Form Scale, and 32 color 2-dimensional stool photographs were shown to 14 pediatric gastroenterologists. Each gastroenterologist rated the stool form depicted in each photograph with the modified stool scale. Ten gastroenterologists agreed to rerate the stool form depicted in each photograph a minimum of 6 months after the first rating.
Results:
A total of 448 ratings were completed; 430 (94%) of all ratings were within at least 1 category type of the most common (modal) rating for each photograph. Eight (25%) stool photographs had complete agreement among all raters. Interrater and intrarater reliability was high with a single measure intraclass correlation of 0.85 (95% confidence interval: 0.78-0.91; P<.001) and 0.87 (95% confidence interval: 0.81-0.92; P<.001), respectively.
Conclusion:
A modified pediatric Bristol Stool Form Scale provided a high degree of interrater reliability, intrarater reliability, and agreement among pediatric gastroenterologists.
