Open AccessThe Modified Bristol Stool Form Scale
Author(s) -
Wegh Carrie A.M.,
Hermes Gerben D.A.,
Schoterman Margriet H.C.,
Vaughan Elaine E.,
Smidt Hauke,
Belzer Clara,
Benninga Marc A.
Publication year - 2021
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000003186
Subject(s) - medicine , intraclass correlation , toilet , grandparent , kappa , inter rater reliability , rating scale , reliability (semiconductor) , pediatrics , psychometrics , clinical psychology , psychology , developmental psychology , linguistics , philosophy , power (physics) , physics , pathology , quantum mechanics
Objective: The aim of the study was to assess whether the modified Bristol Stool Form Scale (m‐BSFS) is reliable, valid and user‐friendly to use by parents, grandparents, and day childcare employees to evaluate stool consistency in toilet and nontoilet‐trained toddlers in the Netherlands. Study design: Translation to Dutch and validity of the m‐BSFS (scoring 32 general stool pictures) for 1 to 3 year old toddlers (n = 89) was evaluated by parents, grandparents, and day childcare employees. A subgroup of participants scored an additional 7 pictures of stools in a diaper to validate the m‐BSFS for non‐toilet‐trained toddlers (n = 16). To determine inter‐rater reliability, 2‐way random effects single‐rater intraclass correlation coefficient (ICC) consistency was used. Intra‐rater reliability was measured by Cohen kappa (κ) by rating the same pictures in random order twice, with at least 1 week between the first and second scoring. Results: Inter‐ and intra‐rater reliability of the m‐BSFS were above recommended minimal standards of 0.61 for the 32 general stool pictures as well as for the 7 pictures of stools in a diaper. ICC consistency for the general stool pictures of the first and second ratings were 0.71 (n = 89) and 0.79 (n = 77), respectively, with a κ of 0.71 (n = 77). ICC consistency for the stools in diaper pictures of the first and second ratings were 0.93 (n = 16) and 0.93 (n = 15), respectively, with a κ of 0.77 (n = 15). Conclusions: The m‐BSFS is reliable, valid and user‐friendly to use by Dutch‐speaking parents, grandparents, and day childcare workers to evaluate stool consistency in both toilet‐ and nontoilet‐trained toddlers in the Netherlands.