title: Development and validation of the Diabetes Bowel Symptom Questionnaire.
abstract: BACKGROUND
  Although gastrointestinal symptoms occur frequently, there is no validated measure of gastrointestinal symptoms in patients with diabetes mellitus.
  
  
  OBJECTIVE
  To develop the Diabetes Bowel Symptom Questionnaire.
  
  
  METHODS
  A questionnaire derived from previously validated symptom measures was compiled to assess all relevant gastrointestinal and diabetes items. Face and content validity were ascertained by expert review. One hundred and sixty-eight patients with diabetes mellitus completed the instrument, and reliability was evaluated by a test-re-test procedure 1 week later. Concurrent validity was evaluated by an independent physician interview (n = 33). Measures of glycaemic control (glycated haemoglobin and plasma glucose) were compared with self-reported glycaemic control on a five-point Likert scale in diabetic out-patients (n = 166).
  
  
  RESULTS
  The questionnaire had adequate face and content validity. There was good to excellent test-re-test reliability for the gastrointestinal and diabetes items (median kappa: 0.63 and 0.79, respectively); concurrent validity was good to excellent (median kappa: 0.47 and 0.65, respectively), except for the items assessing the severity of gastrointestinal symptoms. Both glycated haemoglobin (P < 0.0001) and plasma glucose (P = 0.005) correlated significantly with self-reported glycaemic control.
  
  
  CONCLUSIONS
  The Diabetes Bowel Symptom Questionnaire appears to be a useful measure of gastrointestinal symptoms and glycaemic control in diabetes mellitus, and should have applicability in epidemiological and clinical studies.
authors.affiliation: Department of Medicine, University of Sydney, Nepean Hospital, Sydney, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Quan
authors.forename: N J
authors.initials: NJ
authors.lastname: Talley
authors.forename: S
authors.initials: S
authors.lastname: Cross
authors.forename: M
authors.initials: M
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: Hammer
authors.forename: N
authors.initials: N
authors.lastname: Giles
authors.forename: M
authors.initials: M
authors.lastname: Horowitz
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*