Pediatric GI and Nutrition, Icahn School of Medicine- Mount Sinai Hospital, New York City, NY, USA.
Eli Lilly and Company, 893 Delaware St, Indianapolis, IN, 46225, USA.
Qual Life Res. 2023 Dec;32(12):3403-3415. doi: 10.1007/s11136-023-03494-y. Epub 2023 Aug 4.
Bowel urgency (BU) is an important symptom of Crohn's disease (CD), however there is no patient-reported outcome (PRO) scale validated in this population to assess BU severity. Here we evaluated the content validity and psychometric properties of the Urgency Numeric Rating Scale (NRS).
Qualitative interviews were conducted with moderate-to-severe CD participants to confirm importance and relevance of BU in this population, cognitively debrief the Urgency NRS, and explore score interpretation and CD remission. A quantitative web survey study was conducted to explore the measurement properties of the urgency NRS.
Qualitative Interview: 34 of 35 participants reported BU. It was most bothersome for 44%, 47% reported it daily, 18% with every bowel movement. BU had a severe impact on daily activities, causing many participants to stay home more than preferred. Patients confirmed the relevance, appropriateness, comprehensibility of the item, recall period, response options, and instructions of the Urgency NRS. Small reductions on the Urgency NRS score reflected meaningful improvements. Quantitative survey: The study sample comprised 76 participants (65.8% female). Mean Urgency NRS score was 4.7 (SD 2.26; N = 76) at Week 1, with no floor/ceiling effect. Test-retest reliability was acceptable. Construct and known-groups validity against selected PROs were overall strong and within ranges hypothesized a priori.
The Urgency NRS is a valid and reliable instrument to assess BU severity in CD.
肠紧迫感（BU）是克罗恩病（CD）的一个重要症状，但目前尚无针对该人群的经患者报告结局（PRO）验证的量表来评估 BU 的严重程度。在此，我们评估了紧迫性数字评定量表（NRS）的内容效度和心理测量特性。
对中重度 CD 患者进行定性访谈，以确认 BU 在该人群中的重要性和相关性，对 Urgency NRS 进行认知性审查，并探讨评分解释和 CD 缓解情况。还进行了一项定量网络调查研究，以探索紧迫性 NRS 的测量特性。
定性访谈：35 名参与者中有 34 名报告了 BU。44%的人认为 BU 最令人烦恼，47%的人每天都有 BU，18%的人每次排便都有 BU。BU 对日常活动有严重影响，导致许多参与者比预期更愿意呆在家里。患者确认了 Urgency NRS 项目的相关性、适当性、可理解性、回忆期、应答选项和说明。Urgency NRS 评分的微小减少反映了有意义的改善。定量调查：研究样本包括 76 名参与者（65.8%为女性）。第 1 周时，Urgency NRS 的平均得分为 4.7（SD 2.26；N=76），无地板/天花板效应。测试-重测信度可接受。与选定的 PRO 相比，结构和已知群体的有效性总体上较强，并且在预先假设的范围内。
Urgency NRS 是一种评估 CD 中 BU 严重程度的有效且可靠的工具。
