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Physician-Patient Discordance in Bristol Stool Scale Classification and Overall IBS Burden Assessment
Tal Engel1, Chen Faibis1,2, May Tzur1
1Gastroenterology Institute, Sheba Medical Center, Tel Hashomer and Gray School of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Introduction:
The Bristol Stool Form Scale (BSFS) is widely used to assess stool consistency and subtype irritable bowel syndrome (IBS).
Methods:
Post hoc analysis of a randomized trial comparing patient self-reported BSFS with physician-assessed BSFS. Baseline symptom severity and quality-of-life questionnaires were also collected.
Results:
Agreement was poor across the 7-point scale (κ = -0.01, P = 0.77) and after collapsing into 3 categories (κ = 0.04, P = 0.46), with concordance in only 18/64 cases (28%). Symptom severity and quality-of-life scores were similar between concordant and discordant groups.
Discussion:
Patient-reported BSFS may not reliably reflect stool consistency or overall IBS burden, suggesting caution when using BSFS alone for monitoring or subtyping IBS.
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