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The validity of a symptom diary in ratings of dyspepsia measured against a detailed interview: do patients and clinicians agree in their assessment of symptoms?
Author(s) -
MADSEN L. G.,
HANSEN J. M.,
GRØNVOLD M.,
BYTZER P.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03432.x
Subject(s) - medicine , rating scale , cohen's kappa , kappa , ceiling effect , physical therapy , severity of illness , alternative medicine , psychology , pathology , developmental psychology , linguistics , philosophy , machine learning , computer science
Summary Background Patients’ self‐assessment of symptoms is central in drug treatment trials of functional dyspepsia. The validity of such ratings is important. Aim To validate a diary for monitoring severity and duration of dyspepsia. Method We compared the diary‐cards with two clinicians’ ratings of the patient’s open‐ended responses to the same questions administered by interview. Agreements were evaluated by estimation of the overall agreement and weighted kappa values (Kw). Results Forty‐six patients were evaluated. The Kw between the two clinicians rating severity and duration of symptoms were 0.59 and 0.86, respectively. Overall agreement between patients’ diary rating and clinicians’ consensus rating of severity were 52%, and a moderate agreement with Kw of 0.49 was found. For duration of symptoms the overall agreement and Kw were 67% and 0.59, respectively. Qualitative data revealed useful insight in the possible causes of suboptimal agreement between patients and clinicians. Conclusions We found a moderate to good agreement between patient and observer ratings, indicating that patients to a reasonable extent interpret severity and duration of dyspeptic symptoms in the same way as do investigators. A ceiling effect of the duration scale indicates suboptimal response categories, which should be adjusted before further use.