The Neurogenic Bowel Dysfunction score (NBD) is not suitable for patients with multiple sclerosis

Area of Science:

• Neurology
• Gastroenterology
• Clinical Assessment

Background:

• Bowel and anorectal dysfunctions are prevalent in patients with multiple sclerosis (pwMS).
• Validated questionnaires are crucial for assessing and monitoring these conditions in pwMS.
• The Neurogenic Bowel Dysfunction (NBD) score is widely used but was developed for spinal cord injury patients and lacks validation in other neurological conditions.

Purpose of the Study:

• To evaluate the relevance and psychometric properties of the Neurogenic Bowel Dysfunction (NBD) score in patients with multiple sclerosis (pwMS).
• To determine if the NBD score is a suitable tool for assessing bowel dysfunction in pwMS.

Main Methods:

• A retrospective cohort study was conducted involving 135 pwMS who completed the NBD questionnaire between 2010 and 2021.
• Qualitative and quantitative responses were analyzed to assess content validity.
• Internal consistency was evaluated using Cronbach's alpha.

Main Results:

• The NBD questionnaire demonstrated limitations in content validity, with 4 items deemed inappropriate and 1 item having irrelevant calibration.
• The analysis also identified omissions of commonly used treatments for pwMS.
• Internal consistency was weak, with a Cronbach's alpha of 0.48, indicating poor reliability of the NBD score in this population.

Conclusions:

• The Neurogenic Bowel Dysfunction (NBD) score exhibits inadequate content validity and weak internal consistency when applied to patients with multiple sclerosis (pwMS).
• There is a clear need for a new, disease-specific questionnaire to accurately assess and manage bowel dysfunction in pwMS.
• Developing a tailored instrument will optimize patient care and follow-up for neurogenic bowel issues in multiple sclerosis.