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功能性胃肠病的评估:肠道疾病问卷

Assessment of functional gastrointestinal disease: the bowel disease questionnaire.

作者信息

Talley N J, Phillips S F, Wiltgen C M, Zinsmeister A R, Melton L J

机构信息

Gastroenterology Research Unit, Mayo Clinic, Rochester, MN 55905.

出版信息

Mayo Clin Proc. 1990 Nov;65(11):1456-79. doi: 10.1016/s0025-6196(12)62169-7.

Abstract

A need exists for a self-report questionnaire that reliably and accurately measures symptoms and that distinguishes patients with functional gastrointestinal disease from those with other conditions. We have developed such an instrument, the bowel disease questionnaire, and herein describe details of its discriminatory validity. Data from 399 subjects were analyzed. Patients with gastrointestinal symptoms were ultimately diagnosed as having functional gastrointestinal disease (82 with the irritable bowel syndrome and 33 with functional dyspepsia) or organic gastrointestinal disease (N = 101). There were 145 healthy control subjects and 38 patients with a psychiatric disease, somatoform disorder (which includes those with a diagnosis of hypochrondriasis, psychogenic pain, and somatization or conversion disorder). All subjects completed the questionnaire before undergoing an independent diagnostic assessment by experienced physicians. Functional gastrointestinal disease could be distinguished from organic disease, somatoform disorder, and health by using models derived from logistic discriminant analysis. With use of these models, the estimated probability of functional gastrointestinal disease was then calculated. Descriptive symptom scores were of less value than the scores derived from the data sets by logistic discriminant analysis. Age did not significantly affect the responses to the questionnaire items. We conclude that, in the population studied, the bowel disease questionnaire is a valid measure of symptoms of functional gastrointestinal disease, and this instrument may have clinical and research applications.

摘要

需要一种能可靠且准确地测量症状,并能将功能性胃肠疾病患者与其他疾病患者区分开来的自填式问卷。我们已经开发了这样一种工具——肠道疾病问卷,并在此描述其区分效度的细节。对399名受试者的数据进行了分析。有胃肠道症状的患者最终被诊断为患有功能性胃肠疾病(82例肠易激综合征和33例功能性消化不良)或器质性胃肠疾病(N = 101)。有145名健康对照受试者和38名患有精神疾病——躯体形式障碍的患者(其中包括那些被诊断为疑病症、心因性疼痛以及躯体化或转换障碍的患者)。所有受试者在接受经验丰富的医生进行独立诊断评估之前都完成了问卷。通过使用逻辑判别分析得出的模型,可以将功能性胃肠疾病与器质性疾病、躯体形式障碍以及健康状态区分开来。利用这些模型,随后计算出功能性胃肠疾病的估计概率。描述性症状评分的价值不如通过逻辑判别分析从数据集中得出的评分。年龄对问卷项目的回答没有显著影响。我们得出结论,在所研究的人群中,肠道疾病问卷是功能性胃肠疾病症状的有效测量工具,该工具可能具有临床和研究应用价值。

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