Digestive Disease-Specific Instruments

Development: The Bowel Disease Questionnaire (BDQ) was developed by Talley and colleagues in 1989 as a symptom assessment tool. Items were generated through a review of existing instruments, followed by consultation with gastroenterologists and surgeons and pilot testing with 47 gastroenterology outpatients. The finalized version consists of 46 items assessing gastrointestinal symptoms (abdominal pain, bowel habits, and specific symptoms such as heartburn and nausea). Forty-two additional items assess health history, demographic information, and general psychosomatic symptoms.

Purpose: The BDQ is a diagnostic tool used to assess gastrointestinal symptoms; it was specifically designed to identify patients with functional digestive diseases, as opposed to digestive diseases attributable to "organic" pathology (e.g., structural or biochemical abnormalities) and somatoform diseases. It is not specific to GERD or dyspepsia but may be used in patients with these disorders.

Useful Facts: The BDQ is a self-administered questionnaire with a mean completion time of 17 minutes.¹ Various abbreviated versions of the BDQ have been reported in the literature.

VA Relevance: Literature describing the use of the BDQ in the veteran population was not found.

Availability: The BDQ is reprinted as an appendix to the 1990 developmental article.

References:

1. Talley NJ, Phillips SF, Melton LJ III, Wiltgen C, Zinsmeister AR. A patient questionnaire to identify bowel disease. Ann Intern Med 1989;111:671-674. [Abstract ]
2. Talley NJ, Phillips SF, Wiltgen CM, Zinsmeister AR, Melton LJ III. Assessment of functional gastrointestinal disease: the Bowel Disease Questionnaire. Mayo Clin Proc 1990;65:1456-1479. [Abstract ]
3. Locke GR, Weaver AL, Melton J III, Talley NJ. Psychosocial factors are linked to functional gastrointestinal disorders: a populated based nested case-control study. Am J Gastroenterol 2004;99:350-357. [Abstract ]

Development: Eypasch and colleagues developed the Gastrointestinal Quality of Life Index (GIQLI) beginning in 1990 to provide a measurement tool for assessing subjective well-being in patients with gastrointestinal diseases. An initial item pool generated by the development team was shortened and modified on the basis of pilot data from gastrointestinal patients and their close relatives. The finalized scale consists of 36 items assessing aspects of quality of life: symptoms, emotional functioning, physical status, social functioning, and concerns about medical treatment.

Purpose: The GIQLI is used to assess health-related quality of life in patients with gastrointestinal diseases, including but not limited to functional dyspepsia and GERD. The authors noted that the instrument was not designed as a diagnostic tool or as a means of discriminating between different diseases.

Useful Facts: The GIQLI is a self-administered questionnaire. Completion time is unknown. Items are rated on a scale of 0 to 4 and summed for a total score; some normative data is reported in the 1995 developmental article.² Originally developed in Germany, the GIQLI is also available in English, French, and Spanish translations.

VA Relevance: Literature describing the use of the GIQLI in the veteran population was not found.

Availability: The GIQLI items are printed in Appendix 2 of the 1995 developmental article.²

References:

1. Eypasch E, Troidl H, Wood-Dauphinee S, et al. Quality of life and gastrointestinal surgery - a clinimetric approach to developing an instrument for its measurement. Theor Surg 1990;5:3-10. [Abstract ]
2. Eypasch E, Williams JI, Wood-Dauphine S, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg 1995;82:216-222. [Abstract ]
3. Granderath FA, Kamolz T, Schweiger UM, Pointner R. Long-term follow-up after laparoscopic refundoplication for failed antireflex surgery: quality of life, symptomatic outcome, and patient satisfaction. J Gastrointest Surg 2002;6:812-818. [Abstract ]

Development: The Gastrointestinal Symptom Rating Scale (GSRS) was developed by Svedlund and colleagues in 1988. Items were generated on the basis of literature review and clinical expertise. The GSRS consists of 15 items evaluating the severity of gastrointestinal symptoms (e.g., heartburn, acid regurgitation, abdominal distention, etc.). Five domains have been identified based on the results of factor analysis: abdominal pain, reflux, diarrhea, indigestion, and constipation.

Purpose: The GSRS is a tool for assessing the severity of symptoms associated with various digestive diseases. It has been specifically evaluated for use in populations with GERD.³

Useful Facts: The GSRS was developed as an interviewer-administered scale but has been modified to be self-administered. The interview takes less than 20 minutes to complete; completion time for the self-administered version is not known. Items in the interview version are scored on a 4-point scale, whereas a 7-point scale is used for items in the self-administered version.

VA Relevance: Literature describing the use of the GSRS in the veteran population was not found.

Availability: The GSRS items are described in the appendix to the 1988 developmental article.¹

References:

1. Svedlund J, Sjödin I, Dotevall G. GSRS - a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci 1988;33:129-134. [Abstract ]
2. Dimenäs E, Glise H, Hallerbäck B, Hernqvist H, Svedlund J, Wiklund I. Quality of life in patients with upper gastrointestinal symptoms: an improved evaluation of treatment regimens? Scand J Gastroenterol 1993;28:681-687. [Abstract ]
3. Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the gastrointestinal symptom rating scale in patients with gastroesophageal reflux disease. Qual Life Res 1998;7:75-83. [Abstract ]