Physician-Patient Discordance in Bristol Stool Scale Classification and Overall IBS Burden Assessment

Area of Science:

• Gastroenterology
• Clinical trial analysis
• Patient-reported outcomes

Background:

• The Bristol Stool Form Scale (BSFS) is a key tool for assessing stool consistency.
• It is frequently utilized for the subtyping of Irritable Bowel Syndrome (IBS).

Purpose of the Study:

• To compare patient self-reported BSFS with physician-assessed BSFS.
• To evaluate the reliability of patient-reported BSFS in reflecting stool consistency and IBS burden.

Main Methods:

• Post-hoc analysis of a randomized controlled trial.
• Comparison of patient-reported versus physician-assessed BSFS.
• Collection of baseline symptom severity and quality-of-life data.

Main Results:

• Poor agreement between patient and physician BSFS ratings on a 7-point scale (κ=-0.01) and in three categories (κ=0.04).
• Concordance observed in only 28% of cases.
• Similar symptom severity and quality-of-life scores in both concordant and discordant groups.

Conclusions:

• Patient-reported BSFS may not accurately reflect stool consistency.
• Caution is advised when using patient-reported BSFS for IBS monitoring or subtyping.
• The findings highlight potential limitations in relying solely on patient self-assessment for IBS management.