Symptom-based scoring for haemorrhoidal disease: a systematic review

Area of Science:

• Gastroenterology
• Clinical Research
• Health Outcomes Measurement

Background:

• Haemorrhoidal disease significantly impacts patient quality of life.
• Current classification relies on prolapse morphology, neglecting symptoms and quality of life.
• There is a need for symptom-based severity classification instruments.

Purpose of the Study:

• To systematically review and identify validated instruments for classifying haemorrhoidal disease severity based on symptoms.
• To assess the measurement properties of existing haemorrhoidal symptom scoring systems.

Main Methods:

• A PRISMA-compliant systematic search was conducted in December 2019.
• Studies describing the validation of haemorrhoidal symptom scores were identified.
• Measurement properties were assessed using the COSMIN methodology for patient-reported outcome measures.

Main Results:

• 5288 articles were identified; five studies were included.
• Three studies developed and validated symptom-based scores.
• One study developed a quality of life questionnaire, and another combined symptom and quality of life measures.
• Only one study met satisfactory criteria for validity, reliability, and responsiveness.

Conclusions:

• A single haemorrhoidal symptom score demonstrated sufficient measurement properties for clinical recommendation.
• Further research should adhere to consensus-based standards for validation.
• Improved patient-reported outcome measures are needed for accurate disease burden assessment.