Reviewer's report
Title:Evaluation of the Birmingham IBS Symptom Questionnaire.
Version: 1Date:31 March 2008
Reviewer: Pali Hungin
Reviewer's report:
This is a timely paper in an important area. IBS is a reletively common problem
but we have few means of assessing patients' symptoms even though specific
diagnostic criteria have been laid out in successive Rome consensus reports.
This research, relying on a postal questionnaire to IBS sufferers, describes the
characteristics of a Likert-based symptom questionnaire. It is cross evaluatated
against a QoL questionaire.
The approach used is very reasonable and the results as described indicate the
instrument to be reliable.
However, is is likely to be effective in the clinical setting? A few important points
arise: the subjects consisted of both those with Rome II confirmed IBS and those
with a previous diagnosis (and thus presumably no Rome II confirmation). I am
not sure if the same results might have been obtained from each of these groups.
Including those with a clinical diagnosis is a pragmatic approach but the chief
symptoms evaluated are very much Rome II orientated.
Also, whereas some of the questions were relatively descriptive (eg "loose,
mushy or water bowel motions")others rely entirely on the subjects's own
intrepretation (eg "diarrhoea" or "constipation"). There has to be a question mark
about the clinical reliability of responses to such questions - a case in point is the
differentiation in two different questions between hard bowel motion and
constipation - in practice many patients would regard the former as constipation
whereas most clinicians would relate constipation with infrequent stool. Previous
research has shown disconect between patients' own intrepretations and a Rome
based evaluation.
The paper woulod be strenghtened by including interviews, or, by an explanation
of how the difficulties above are overcome overcome in commending this
questionnaire. The risk is that the instrument itself may have scored very well (it
has!) but that it does not describe accurately what the patient's problems actually
are in the real life situation. Also, other factors such as bloating or tiredness did
not appear in the symptom evaluation questionaaire even though they are
regareded as part if IBS. Does this matter here?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Evaluation of the Birmingham IBS Symptom Questionnaire.
Version: 1Date:31 March 2008
Reviewer: Pali Hungin
Reviewer's report:
This is a timely paper in an important area. IBS is a reletively common problem
but we have few means of assessing patients' symptoms even though specific
diagnostic criteria have been laid out in successive Rome consensus reports.
This research, relying on a postal questionnaire to IBS sufferers, describes the
characteristics of a Likert-based symptom questionnaire. It is cross evaluatated
against a QoL questionaire.
The approach used is very reasonable and the results as described indicate the
instrument to be reliable.
However, is is likely to be effective in the clinical setting? A few important points
arise: the subjects consisted of both those with Rome II confirmed IBS and those
with a previous diagnosis (and thus presumably no Rome II confirmation). I am
not sure if the same results might have been obtained from each of these groups.
Including those with a clinical diagnosis is a pragmatic approach but the chief
symptoms evaluated are very much Rome II orientated.
Also, whereas some of the questions were relatively descriptive (eg "loose,
mushy or water bowel motions")others rely entirely on the subjects's own
intrepretation (eg "diarrhoea" or "constipation"). There has to be a question mark
about the clinical reliability of responses to such questions - a case in point is the
differentiation in two different questions between hard bowel motion and
constipation - in practice many patients would regard the former as constipation
whereas most clinicians would relate constipation with infrequent stool. Previous
research has shown disconect between patients' own intrepretations and a Rome
based evaluation.
The paper woulod be strenghtened by including interviews, or, by an explanation
of how the difficulties above are overcome overcome in commending this
questionnaire. The risk is that the instrument itself may have scored very well (it
has!) but that it does not describe accurately what the patient's problems actually
are in the real life situation. Also, other factors such as bloating or tiredness did
not appear in the symptom evaluation questionaaire even though they are
regareded as part if IBS. Does this matter here?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Evaluation of the Birmingham IBS Symptom Questionnaire.
Version: 1Date:31 March 2008
Reviewer: Pali Hungin
Reviewer's report:
This is a timely paper in an important area. IBS is a reletively common problem
but we have few means of assessing patients' symptoms even though specific
diagnostic criteria have been laid out in successive Rome consensus reports.
This research, relying on a postal questionnaire to IBS sufferers, describes the
characteristics of a Likert-based symptom questionnaire. It is cross evaluatated
against a QoL questionaire.
The approach used is very reasonable and the results as described indicate the
instrument to be reliable.
However, is is likely to be effective in the clinical setting? A few important points
arise: the subjects consisted of both those with Rome II confirmed IBS and those
with a previous diagnosis (and thus presumably no Rome II confirmation). I am
not sure if the same results might have been obtained from each of these groups.
Including those with a clinical diagnosis is a pragmatic approach but the chief
symptoms evaluated are very much Rome II orientated.
Also, whereas some of the questions were relatively descriptive (eg "loose,
mushy or water bowel motions")others rely entirely on the subjects's own
intrepretation (eg "diarrhoea" or "constipation"). There has to be a question mark
about the clinical reliability of responses to such questions - a case in point is the
differentiation in two different questions between hard bowel motion and
constipation - in practice many patients would regard the former as constipation
whereas most clinicians would relate constipation with infrequent stool. Previous
research has shown disconect between patients' own intrepretations and a Rome
based evaluation.
The paper woulod be strenghtened by including interviews, or, by an explanation
of how the difficulties above are overcome overcome in commending this
questionnaire. The risk is that the instrument itself may have scored very well (it
has!) but that it does not describe accurately what the patient's problems actually
are in the real life situation. Also, other factors such as bloating or tiredness did
not appear in the symptom evaluation questionaaire even though they are
regareded as part if IBS. Does this matter here?
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
assistant