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Validating a novel scoring system for the assessment and treatment of functional gastrointestinal disorders in
Bhaswati Chakrabarti Acharyya1,2, Pritha Das1, Meghdeep Mukhopadhyay1
1Department of Pediatric Gastroenterology and Hepatology, Institute of Child Health, Kolkata 700017, West Bengal, India.
Insights
A new scoring system effectively assesses symptom severity in pediatric functional gastrointestinal disorders (FGIDs). This tool aids in understanding FGIDs and guides treatment decisions for children.
Area of Science:
- Pediatric Gastroenterology
- Gut-Brain Interaction Disorders
- Clinical Assessment Tools
Background:
- Functional gastrointestinal disorders (FGIDs), or Disorders of Gut-Brain Interaction, are a significant global health concern.
- Existing assessment tools for FGIDs lack comprehensive symptom evaluation, particularly for pediatric populations.
- A novel 16-symptom scoring system, Bacharyya's Questionnaire Scale, was developed for pediatric FGIDs.
Purpose of the Study:
- To validate the Bacharyya's Questionnaire Scale for assessing symptom severity in pediatric FGIDs.
- To determine the scale's utility in evaluating treatment response in children with FGIDs.
- To establish the clinical applicability of this new scoring system.
Main Methods:
- Children aged 5-18 diagnosed with FGIDs (ROME IV criteria) completed the Bacharyya's Questionnaire Scale and a Visual Analog Scale.
- Data were collected at initial diagnosis and after a 2-month treatment period.
- A control group without FGIDs was included for baseline comparison; treatment response was defined as ≥50% score reduction.
Main Results:
- The study included 190 FGID cases and 90 controls, with functional constipation and functional abdominal pain being prevalent.
- Spearman rank correlation showed significant positive results for pre-treatment (r=0.72) and post-treatment (r=0.49) scores (P<0.0001).
- 96 children showed symptom improvement post-treatment, indicating the scale's sensitivity to change.
Conclusions:
- The Bacharyya's Questionnaire Scale demonstrates high comprehensibility and provides an objective measure of FGID symptomatology in children.
- This novel scoring system can aid in characterizing pediatric FGIDs.
- Implementing this scale in clinical practice can enhance treatment decision-making for FGIDs.
Background:
Functional gastrointestinal disorders (FGIDs), defined as 'Disorders of Gut-Brain Interaction', are now considered a global health problem. There is a dearth of concepts and scales to assess the severity of the different symptoms encountered while dealing with the variety of FGIDs as described in the ROME IV classification. We introduced a novel scoring system with the incorporation of 16 different symptoms called Bacharyya's Questionnaire Scale and started using it while dealing with children suffering from FGIDs.
Aim:
To verify the usefulness and applicability of this recently developed scale, this study was undertaken with the objectives to establish the validity of this scoring system in assessing the severity of symptoms associated with a specific FGID in children and to determine the scoring system's applicability in assessing the treatment response.
Methods:
The study included children aged 5 to 18 years diagnosed with any FGID based on ROME IV criteria. They completed the newly developed scale and a Visual Analog Scale at initial diagnosis and after a 2-month treatment period. A control group without FGID participated for comparative baseline purposes. Treatment response was defined as a less than or equal to 50% reduction in the total score, which is statistically significant.
Results:
Results from a comprehensive cohort of 190 cases and 90 controls indicated a female preponderance (57.9%) and prevalent disorders such as functional constipation (28%) and functional abdominal pain, not otherwise specified (21%). The grade of FGID (mild, moderate, severe) experienced by the patients was also derived. Post-treatment, 96 children demonstrated symptom improvement. The Spearman rank correlation coefficient for pre (r = 0.72, 95%CI: 0.65-0.77, P value < 0.0001) and post (r = 0.49, 95%CI: 0.3-0.64, P value < 0.0001) treatment data showed positive results with significant P values.
Conclusion:
The novel scoring system shows high comprehensibility and gives an objective view of the symptomatology of FGIDs. The use of this novel score in clinical settings will be helpful to typify the FGIDs and may significantly improve decision-making processes to initiate appropriate treatment.
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