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Assessment and validation of a screening questionnaire for the diagnosis of pediatric bladder and bowel dysfunction
T Anwar1, C S Cooper1, G Lockwood1
1University of Iowa, Departments of Urology, USA.
Insights
A new questionnaire objectively diagnoses pediatric bladder and bowel dysfunction (BBD). This validated instrument reliably quantifies BBD symptoms in children, aiding diagnosis and classification.
Area of Science:
- Pediatric Urology
- Clinical Assessment Tools
- Child Health
Background:
- Pediatric bladder and bowel dysfunction (BBD) is common but lacks validated diagnostic instruments.
- Existing questionnaires often lack psychometric validation, limiting accurate diagnosis and quantification.
- A new objective instrument was developed to address these limitations in pediatric BBD assessment.
Purpose of the Study:
- To evaluate the performance of a newly developed questionnaire for diagnosing pediatric BBD.
- To objectively quantify the symptomatology of BBD in children.
- To assess the reliability and validity of the new diagnostic instrument.
Main Methods:
- An 18-item, 5-point questionnaire was created based on literature review and expert opinion.
- The questionnaire covered six symptom categories: nocturnal enuresis, lower urinary tract symptoms, urinary holding, infrequent urination, bowel symptoms, and daytime urinary incontinence.
- A cohort of 1265 pediatric patients (758 cases, 507 controls) completed the questionnaire, and scores were compared between groups.
Main Results:
- The new BBD questionnaire demonstrated a significant difference in total scores between cases (mean 23) and controls (mean 8) (p < 0.001).
- Reliability analysis yielded a Cronbach's alpha coefficient of 0.80, indicating good internal consistency.
- The instrument effectively differentiated between children with and without BBD.
Conclusions:
- The developed questionnaire is a valid and reliable tool for diagnosing pediatric BBD.
- It enables objective quantification of BBD symptoms and classification of patients into specific subcategories.
- This instrument improves the diagnostic capabilities for pediatric bladder and bowel dysfunction.
Introduction:
Pediatric bladder and bowel dysfunction (BBD) is a common problem in children. However, the current ability to diagnosis and quantify pediatric BBD is limited as only a few validated instruments exist. In addition, the current questionnaires are limited by their lack of psychometric processing and methods of validation. To address these issues, the authors developed a new questionnaire to objectively diagnose pediatric BBD symptoms. This study aimed to evaluate the performance of this newly devised objective instrument in diagnosing and quantifying the symptomatology of BBD in children.
Materials And Methods:
An 18-item, 5-point questionnaire was developed using both a literature review and expert opinions. The total questionnaire score could range from 0 to 72. Questions were subgrouped into six symptom categories: (1) nocturnal enuresis, (2) lower urinary tract symptoms, (3) urinary holding, (4) infrequent urination, (5) bowel symptoms, and (6) daytime urinary incontinence. The questionnaire also assessed the degree of bother associated with the symptoms. Patients were divided into cases and controls, and these two groups were compared.
Discussion/Results:
A total of 1265 new patients (758 cases and 507 controls) completed the new BBD questionnaire. The mean age of the whole study cohort was 9.5 years (range, 3-19 years). The total mean questionnaire score was significantly higher at 23 (3-58) in the cases, compared with 8 (0-35) in the controls (p < 0.001) (Summary Figure). Reliability analysis of the 18-item instrument showed a Cronbach's alpha reliability coefficient of 0.80 for the scale.
Conclusions:
This new instrument provides a valid and reliable method for diagnosis of pediatric BBD and classification of patients into subcategories of BBD based on their specific symptoms.
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