el-Omar E M, Banerjee S, Wirz A, McColl K E
University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK.
Eur J Gastroenterol Hepatol. 1996 Oct;8(10):967-71. doi: 10.1097/00042737-199610000-00006.
There is currently no reliable tool for providing a global measurement of the severity of dyspepsia in patients with a variety of upper gastrointestinal disorders. We have designed a questionnaire which records frequency of symptoms, effect on routine activities, time off work, frequency of medical consultations, clinical investigations and use of over-the-counter and prescribed medications. The objective of the paper was to assess this questionnaire with respect to reproducibility, validity, responsiveness and performance time.
For intra-observer variation, one author interviewed 50 subjects (25 males) including 20 healthy volunteers and 30 with a variety of upper gastrointestinal pathologies. The interview was repeated one week later by the same author who was blinded to the dyspepsia score for the first interview. The second author, who was blinded to the diagnoses and subject identity, scored all the questionnaires. The mean dyspepsia score was 6.78 on Day 1 and was similar at 6.80 on Day 2. The coefficient of variation between Days 1 and 2 was 2%. For inter-observer variation, 30 patients with non-ulcer dyspepsia (NUD) were interviewed by one author and the interview was repeated on a separate occasion within 24 h by a second author who was blinded to the score from the first interview. The mean dyspepsia score for the first author was 10.7 and for the second author 10.9 with a coefficient of variation between the two authors of 8%. Validity was assessed by comparing the dyspepsia scores in healthy volunteers and patients with upper gastrointestinal diseases. The mean score in 80 healthy volunteers was 1.16 (range: 0-7) and was significantly higher in 70 duodenal ulcer (DU) patients (mean score 11.1, range: 6-16) and 80 NUD patients (mean score 10.5, range: 6-17) (P < 0.001 for both vs. healthy volunteers). Responsiveness was assessed by comparing dyspepsia scores before and one year after eradication of Helicobacter pylori infection in 42 DU patients. The mean dyspepsia score before eradication was 11.4 (range: 6-16) and fell to 1.33 (range: 0-11) one year after eradication (P < 0.001). The mean time taken to complete 150 questionnaires was 4 min (range: 3-5.5 min).
This new questionnaire for assessing the severity of dyspepsia is highly reproducible and has high validity and responsiveness. In addition, it is simple and rapid to perform. It provides a valuable tool for assessing the response to treatment in patients with dyspepsia.
目前尚无可靠工具可对患有各种上消化道疾病的患者消化不良的严重程度进行全面评估。我们设计了一份问卷，用于记录症状出现频率、对日常活动的影响、误工时间、就医频率、临床检查以及非处方和处方药的使用情况。本文的目的是评估该问卷在可重复性、有效性、反应性和完成时间方面的表现。
对于观察者内变异，一位作者对50名受试者（25名男性）进行了访谈，其中包括20名健康志愿者和30名患有各种上消化道疾病的患者。一周后，同一位作者在对首次访谈的消化不良评分不知情的情况下重复进行了访谈。第二位作者在对诊断和受试者身份不知情的情况下对所有问卷进行评分。第1天的平均消化不良评分为6.78，第2天为6.80，两者相似。第1天和第2天之间的变异系数为2%。对于观察者间变异，一位作者对30名非溃疡性消化不良（NUD）患者进行了访谈，另一位作者在24小时内单独进行了重复访谈，且对首次访谈的评分不知情。第一位作者的平均消化不良评分为10.7，第二位作者为10.9，两位作者之间的变异系数为8%。通过比较健康志愿者和上消化道疾病患者的消化不良评分来评估有效性。80名健康志愿者的平均评分为1.16（范围：0 - 7），70名十二指肠溃疡（DU）患者（平均评分11.1，范围：6 - 16）和80名NUD患者（平均评分10.5，范围：6 - 17）的评分显著更高（与健康志愿者相比，两者P均<0.001）。通过比较42名DU患者根除幽门螺杆菌感染前后的消化不良评分来评估反应性。根除前的平均消化不良评分为11.4（范围：6 - 16），根除一年后降至1.33（范围：0 - 11）（P<0.001）。完成150份问卷的平均时间为4分钟（范围：3 - 5.5分钟）。
这份用于评估消化不良严重程度的新问卷具有高度可重复性、高有效性和反应性。此外，它操作简单、迅速。它为评估消化不良患者的治疗反应提供了一个有价值的工具。
