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?
BACKGROUND
Patients' self-assessment of symptoms is central in drug treatment trials of functional dyspepsia. The validity of such ratings is important.


OBJECTIVE
To validate a diary for monitoring severity and duration of dyspepsia.


METHODS
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.
Madsen
L G
LG
Department of Medical Gastroenterology, Glostrup University Hospital, Glostrup, Denmark.
Hansen
J M
JM
Grønvold
M
M
Bytzer
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004415:Dyspepsia / Q000145:classification / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010820:Physicians; D011788:Quality of Life / Q000523:psychology; D012647:Self-Assessment; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires