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Bristol Stool Form Scale reliability and agreement decreases when determining Rome III stool form designations.

B P Chumpitazi1,2, M M Self1,3, D I Czyzewski1,2,3

  • 1Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.

Neurogastroenterology and Motility
|December 23, 2015
PubMed
Summary
This summary is machine-generated.

The Bristol Stool Form Scale (BSFS) shows excellent rater reliability for individual stool types. However, its reliability decreases when classifying stools as normal or abnormal using Rome III criteria.

Keywords:
constipationdiarrheairritable bowel syndromestool form

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Area of Science:

  • Gastroenterology
  • Medical Diagnostics
  • Clinical Assessment

Background:

  • The reproducibility of the Bristol Stool Form Scale (BSFS) for categorizing stool types is not well-established.
  • Assessing reliability and agreement for individual stool types and Rome III clinical designations is crucial.

Purpose of the Study:

  • To determine the inter-rater and intra-rater reliability and agreement of the BSFS.
  • To evaluate BSFS reliability when stool types are categorized as normal or abnormal based on Rome III criteria.

Main Methods:

  • Thirty-four gastroenterology providers rated 35 stool photographs using the BSFS.
  • Twenty providers rerated the same photographs to assess intra-rater reliability.

Main Results:

  • Individual stool type ratings showed excellent inter-rater (ICC=0.88) and intra-rater (ICC=0.89) reliability.
  • General agreement was high, with 95.1% of ratings within one category of the modal rating.
  • Reliability decreased when using Rome III designations (inter-rater ICC=0.75, intra-rater ICC=0.65), particularly at the boundaries between normal and abnormal stools.

Conclusions:

  • The BSFS demonstrates excellent reliability and agreement for individual stool type assessment.
  • BSFS reliability and agreement are reduced when used for Rome III clinical stool form categorization.