Koppen Ilan J N, Velasco-Benitez Carlos A, Benninga Marc A, Di Lorenzo Carlo, Saps Miguel
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH; Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands.
Department of Pediatrics, Universidad del Valle, Cali, Colombia.
J Pediatr. 2016 Oct;177:44-48.e1. doi: 10.1016/j.jpeds.2016.06.055. Epub 2016 Jul 22.
To evaluate among parents of infants and toddlers the agreement between parental report and the Bristol Stool Scale (BSS) in assessing stool consistency and the effect of both methods on determining the prevalence of functional constipation (FC) according to the Rome III criteria.
Parents of children ≤48 months of age who were seen for a well-child visit completed a questionnaire about their child's bowel habits during the previous month. Cohen kappa coefficient (κ) was used to measure intrarater agreement between parental report of stool consistency ("hard," "normal," "soft/mucous/liquid") and the BSS (types 1-2, hard; types 3-5, normal; types 6-7, loose/liquid). The prevalence of FC was assessed based on the questionnaire according to the Rome III criteria, comparing both methods of stool consistency assessment.
Parents of 1095 children (median age, 15 months; range, 1-48) were included. Only fair agreement existed between the 2 methods of stool consistency assessment (κ = 0.335; P < .001). According to the Rome III criteria, using parental report the prevalence of FC was 20.5% and using the BSS the prevalence was 20.9% (P = .87). The agreement between these 2 methods for assessing the prevalence of FC was excellent (κ = 0.95; P < .001).
Only fair agreement exists between the BSS and parental report of stool consistency among parents of infants and toddlers. Different methods of stool consistency assessment did not result in a difference in the prevalence of FC.
在婴幼儿家长中评估家长报告与布里斯托大便分类法（BSS）在评估大便稠度方面的一致性，以及这两种方法对根据罗马Ⅲ标准确定功能性便秘（FC）患病率的影响。
因健康儿童就诊而接受检查的48个月及以下儿童的家长完成了一份关于其孩子前一个月排便习惯的问卷。采用科恩kappa系数（κ）来衡量家长对大便稠度的报告（“硬”、“正常”、“软/黏液/液体”）与BSS（1 - 2型，硬；3 - 5型，正常；6 - 7型，稀/液体）之间的评分者内一致性。根据问卷，按照罗马Ⅲ标准评估FC的患病率，比较两种大便稠度评估方法。
纳入了1095名儿童的家长（中位年龄15个月；范围1 - 48个月）。两种大便稠度评估方法之间仅存在中等程度的一致性（κ = 0.335；P < 0.001）。根据罗马Ⅲ标准，采用家长报告法FC的患病率为20.5%，采用BSS法患病率为20.9%（P = 0.87）。这两种评估FC患病率的方法之间的一致性极佳（κ = 0.95；P < 0.001）。
在婴幼儿家长中，BSS与家长对大便稠度的报告之间仅存在中等程度的一致性。不同的大便稠度评估方法并未导致FC患病率的差异。
