Background In functional gastrointestinal disorders patient recall of symptoms drives diagnostic

Background In functional gastrointestinal disorders patient recall of symptoms drives diagnostic decisions and evaluation of treatment response as well as research conclusions about potential treatments. and Bland-Altman plots assessed agreement. Key Results For pain and days without bowel movement Cambendazole overall agreement between child recall questionnaire and child diary was strong though under conditions likely to facilitate agreement and with individual variation observed. Parent recall and child diary were less concordant and agreement about diarrhea was poor for parent and child. Age did not significantly correlate with agreement. Conclusions & Inferences Child questionnaire with short recall interval may be a reasonable approximation for diary data though this varies by individual and replication/investigation of lengthier recall are needed. Relying on parent questionnaire does not appear a suitable proxy and recall of stool form by both parent and child appears more problematic. These results combined with existing literature support use of diary data whenever possible. Cambendazole Keywords: functional gastrointestinal disorders irritable bowel syndrome Rome III questionnaire pain diary children and adolescents Clinical decision-making about diagnosis and treatment is usually routinely guided by patient report of symptoms with symptom recall critically influencing medical management particularly for conditions lacking objective indicators such as functional gastrointestinal Cambendazole disorders (FGIDs). In research patient-reported outcomes are increasingly conceptualized as primary endpoints1 2 emphasizing patient report in evaluating potential treatments. Health-related information recalled via questionnaire has been questioned as unreliable or subject Rabbit Polyclonal to AIBP. to bias.3 For example peak and end effects (i.e. most intense and most recent pain) disproportionately influence pain recall and can undermine validity of retrospective self-reports.3-13 Recalled pain ratings are typically higher than momentary assessments and lengthening recall interval magnifies bias.4 9 11 13 Despite these limitations retrospective questionnaires are used routinely and endorsed for assessing symptoms in FGID treatment trials1. Given this endorsement and the burden of diaries20 evaluating if questionnaires are a sufficient proxy is advantageous. Most literature evaluating correspondence between recalled and recorded symptoms involves non-GI samples but evidence suggests GI symptoms are subject to recall error or that recalled and recorded bowel function diverge.21-27 This small literature is often limited by lack of correspondence between questionnaire and diary intervals (e.g. questionnaires preceding diary). This challenges interpretation but adult IBS literature suggests that subtyping differs Cambendazole based on recalled versus recorded data26 27 Rome III Diagnostic Questionnaires may overestimate the frequency of abnormal stool form26 participants tend to recall more extreme stool forms as representative27 28 and those describing constipation underestimate stool frequency on questionnaire.23 24 Lackner and colleagues recently reported that though as a group adults with IBS accurately recalled some IBS symptoms individual Cambendazole correspondence varied with a subset of patients evidencing poor recall accuracy.28 Few studies Cambendazole examine correspondence between recalled and recorded pain in children particularly in GI samples. Available research employs variable methods and yields variable interpretations concerning children’s recall accuracy. Accuracy usually increases with age recalled pain ratings tend to be higher than momentary ratings (though pediatric findings are more mixed) and peak- and end-effects similarly bias ratings.14 18 29 Even less pediatric research concerns recalled versus recorded stool data though evidence suggests recalled and recorded defecation frequency do not closely correspond and methodology affects diagnostic classification.33 One study by Chogle and colleagues34 examined correspondence between recalled and recorded pain in pediatric FGIDs comparing a four-week pain diary to retrospective report of number of pain days. Results reflected a moderate positive correlation (Spearman correlation.