Development of a digestive health status instrument: tests of scaling assumptions, structure and reliability in a primary care population

Aliment Pharmacol Ther. 1998 Nov;12(11):1067-78. doi: 10.1046/j.1365-2036.1998.00399.x.


Background: The absence of valid and reliable health status measures for functional gastrointestinal illness has limited research and patient care for this common group of disorders. A self-report survey has been developed.

Methods: Initial development focused on extensive pre-testing of patients, primary care physicians and gastroenterologists. The disease-specific portion included the Rome criteria for dyspepsia subgroups and the Manning and Rome criteria for irritable bowel syndrome. The Short Form-36 was added. Psychometric analyses included techniques of multitrait scaling, scale internal consistency and criterion validation.

Results: Six hundred and ninety patients presenting to their primary care physician for treatment of heartburn, abdominal pain or discomfort completed the 98 question survey. The disease-specific portion revealed five components including reflux, dysmotility, a two-domain bowel dysfunction complex, and a pain index. Internal consistency measures demonstrated good to excellent reliability. Scaling successes were observed on multitrait scaling. The disease-specific portion was reduced to 34 questions. Criterion validity was demonstrated with the correlation of the disease-specific questions to the SF-36.

Conclusions: The psychometric analyses lend credence to the concept of stomach and bowel symptom subgrouping as proposed by expert consensus. The psychometric properties of the five summated disease-specific scales compare favourably with standardized health status measures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Colonic Diseases, Functional / diagnosis*
  • Colonic Diseases, Functional / psychology
  • Factor Analysis, Statistical
  • Female
  • Health Status Indicators*
  • Humans
  • Male
  • Primary Health Care
  • Psychometrics
  • Quality of Life
  • Surveys and Questionnaires*