title: Systematic review of strategies to measure HIV-related diarrhea.
abstract: BACKGROUND
  In the highly active antiretroviral therapy (HAART) era, HIV-related diarrhea remains common. There is no gold standard to measure diarrhea, making comparison across trials difficult. We conducted a systematic review to determine current research practice in measuring HIV-related diarrhea.
  
  
  METHODS
  MEDLINE was searched from 1980 to 2006 for clinical trials of treatment for HIV-related diarrhea. The following data were abstracted: type of trial, treatment studied, definition of diarrhea, and definition of improvement in diarrhea.
  
  
  RESULTS
  We reviewed 384 articles; 46 met our inclusion criteria. Forty-two trials were prospective: 25 were open-label and 17 were controlled trials. Antimicrobials were studied most often (15 trials): octreotide was studied in 10 trials, and HAART in 5. Presence of diarrhea was most often defined by duration (33 trials, 72%), stool frequency (29 trials, 63%), and/or stool form (23 trials, 50%); often, more than one parameter was used. Stool frequency was used most often to measure diarrhea improvement (28 trials, 61%). Only one trial used a measure validated for HIV-related diarrhea.
  
  
  CONCLUSIONS
  Investigators rely on non-validated and disparate measures of HIV-related diarrhea. An easy-to-use, well-accepted, and valid tool to measure HIV-related diarrhea would enhance research in this field.
authors.affiliation: Division of Gastroenterology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. jill.tinmouth@sunnybrook.ca
authors.forename: Jill
authors.initials: J
authors.lastname: Tinmouth
authors.forename: Gabor
authors.initials: G
authors.lastname: Kandel
authors.forename: George
authors.initials: G
authors.lastname: Tomlinson
authors.forename: Sharon
authors.initials: S
authors.lastname: Walmsley
authors.forename: Hillary A
authors.initials: HA
authors.lastname: Steinhart
authors.forename: Richard
authors.initials: R
authors.lastname: Glazier
mesh_terms: D003967:Diarrhea / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016896:Treatment Outcome