No validated patient-reported outcome measure exists for functional dyspepsia assessment.
Verbal descriptions of different upper abdominal symptoms may be poorly distinguishable to patients.
Professor Tack and colleagues from Belgium investigate whether understanding of functional dyspepsia symptoms is enhanced by pictograms symbolizing the nature of the symptoms, besides verbal descriptors.
Consecutive functional dyspepsia patients were randomised to fill out a questionnaire assessing nineupper gastrointestinal symptoms with or without accompanying pictograms.
The team rated symptoms for frequency and severity, and patients also identified the most bothersome symptom.
|Concordance with clinician's assessment rose to 48% for questions with pictograms|
|Alimentary Pharmacology & Therapeutics|
Subsequently, in-depth history was taken by an expert clinician, who filled out the same symptom ratings.
Concordance between patient and clinician ratings was quantified using chi-square and kappa statistics.
The research team first confirmed content validity of pictograms by 15 functional dyspepsia patients.
Next, 76 patients were randomized to questionnaires with or without pictograms.
The research team found that concordance with clinician's assessment as gold standard rose from 36% without to 48% for questions with pictograms.
Considering the Rome III subdivision, benefit in concordance with pictograms was present for post-prandial distress, epigastric pain syndrome and reflux symptoms.
Professor Tack's team concludes, "Pictograms accompanying verbal descriptors significantly improve concordance of functional dyspepsia symptom ratings by patients with evaluation by their physicians."