The validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for evaluating symptoms in the clinical setting

N. A. Koloski, M. Jones, J. Hammer, M. von Wulffen, A. Shah, H. Hoelz, M. Kutuyla, D. Burger, N. Martin, S. R. Gurusamy, N. J. Talley, G. Holtmann

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The clinical assessments of patients with gastrointestinal symptoms can be time-consuming, and the symptoms captured during the consultation may be influenced by a variety of patient and non-patient factors. To facilitate standardized symptom assessment in the routine clinical setting, we developed the Structured Assessment of Gastrointestinal Symptom (SAGIS) instrument to precisely characterize symptoms in a routine clinical setting. Aims: We aimed to validate SAGIS including its reliability, construct and discriminant validity, and utility in the clinical setting. Methods: Development of the SAGIS consisted of initial interviews with patients referred for the diagnostic work-up of digestive symptoms and relevant complaints identified. The final instrument consisted of 22 items as well as questions on extra intestinal symptoms and was given to 1120 consecutive patients attending a gastroenterology clinic randomly split into derivation (n = 596) and validation datasets (n = 551). Discriminant validity along with test–retest reliability was assessed. The time taken to perform a clinical assessment with and without the SAGIS was recorded along with doctor satisfaction with this tool. Results: Exploratory factor analysis conducted on the derivation sample suggested five symptom constructs labeled as abdominal pain/discomfort (seven items), gastroesophageal reflux disease/regurgitation symptoms (four items), nausea/vomiting (three items), diarrhea/incontinence (five items), and difficult defecation and constipation (2 items). Confirmatory factor analysis conducted on the validation sample supported the initially developed five-factor measurement model ((Formula presented.), p < 0.0001, χ2/df = 4.6, CFI = 0.90, TLI = 0.88, RMSEA = 0.08). All symptom groups demonstrated differentiation between disease groups. The SAGIS was shown to be reliable over time and resulted in a 38% reduction of the time required for clinical assessment. Conclusions: The SAGIS instrument has excellent psychometric properties and supports the clinical assessment of and symptom-based categorization of patients with a wide spectrum of gastrointestinal symptoms.

LanguageEnglish
Pages1913–1922
Number of pages10
JournalDigestive Diseases and Sciences
Volume62
Issue number8
DOIs
Publication statusPublished - Aug 2017

Fingerprint

Symptom Assessment
Statistical Factor Analysis
Defecation
Gastroenterology
Constipation
Gastroesophageal Reflux
Psychometrics
Reproducibility of Results
Nausea
Abdominal Pain
Vomiting
Diarrhea
Referral and Consultation
Interviews

Keywords

  • questionnaire development
  • validation
  • irritable bowel syndrome
  • quality of life
  • gastrointestinal symptoms

Cite this

Koloski, N. A. ; Jones, M. ; Hammer, J. ; von Wulffen, M. ; Shah, A. ; Hoelz, H. ; Kutuyla, M. ; Burger, D. ; Martin, N. ; Gurusamy, S. R. ; Talley, N. J. ; Holtmann, G. / The validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for evaluating symptoms in the clinical setting. In: Digestive Diseases and Sciences. 2017 ; Vol. 62, No. 8. pp. 1913–1922.
@article{704fb6f6845b4effbf67fbdf87433d20,
title = "The validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for evaluating symptoms in the clinical setting",
abstract = "Background: The clinical assessments of patients with gastrointestinal symptoms can be time-consuming, and the symptoms captured during the consultation may be influenced by a variety of patient and non-patient factors. To facilitate standardized symptom assessment in the routine clinical setting, we developed the Structured Assessment of Gastrointestinal Symptom (SAGIS) instrument to precisely characterize symptoms in a routine clinical setting. Aims: We aimed to validate SAGIS including its reliability, construct and discriminant validity, and utility in the clinical setting. Methods: Development of the SAGIS consisted of initial interviews with patients referred for the diagnostic work-up of digestive symptoms and relevant complaints identified. The final instrument consisted of 22 items as well as questions on extra intestinal symptoms and was given to 1120 consecutive patients attending a gastroenterology clinic randomly split into derivation (n = 596) and validation datasets (n = 551). Discriminant validity along with test–retest reliability was assessed. The time taken to perform a clinical assessment with and without the SAGIS was recorded along with doctor satisfaction with this tool. Results: Exploratory factor analysis conducted on the derivation sample suggested five symptom constructs labeled as abdominal pain/discomfort (seven items), gastroesophageal reflux disease/regurgitation symptoms (four items), nausea/vomiting (three items), diarrhea/incontinence (five items), and difficult defecation and constipation (2 items). Confirmatory factor analysis conducted on the validation sample supported the initially developed five-factor measurement model ((Formula presented.), p < 0.0001, χ2/df = 4.6, CFI = 0.90, TLI = 0.88, RMSEA = 0.08). All symptom groups demonstrated differentiation between disease groups. The SAGIS was shown to be reliable over time and resulted in a 38{\%} reduction of the time required for clinical assessment. Conclusions: The SAGIS instrument has excellent psychometric properties and supports the clinical assessment of and symptom-based categorization of patients with a wide spectrum of gastrointestinal symptoms.",
keywords = "questionnaire development, validation, irritable bowel syndrome, quality of life, gastrointestinal symptoms",
author = "Koloski, {N. A.} and M. Jones and J. Hammer and {von Wulffen}, M. and A. Shah and H. Hoelz and M. Kutuyla and D. Burger and N. Martin and Gurusamy, {S. R.} and Talley, {N. J.} and G. Holtmann",
year = "2017",
month = "8",
doi = "10.1007/s10620-017-4599-6",
language = "English",
volume = "62",
pages = "1913–1922",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer, Springer Nature",
number = "8",

}

Koloski, NA, Jones, M, Hammer, J, von Wulffen, M, Shah, A, Hoelz, H, Kutuyla, M, Burger, D, Martin, N, Gurusamy, SR, Talley, NJ & Holtmann, G 2017, 'The validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for evaluating symptoms in the clinical setting', Digestive Diseases and Sciences, vol. 62, no. 8, pp. 1913–1922. https://doi.org/10.1007/s10620-017-4599-6

The validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for evaluating symptoms in the clinical setting. / Koloski, N. A.; Jones, M.; Hammer, J.; von Wulffen, M.; Shah, A.; Hoelz, H.; Kutuyla, M.; Burger, D.; Martin, N.; Gurusamy, S. R.; Talley, N. J.; Holtmann, G.

In: Digestive Diseases and Sciences, Vol. 62, No. 8, 08.2017, p. 1913–1922.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The validity of a New Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS) for evaluating symptoms in the clinical setting

AU - Koloski, N. A.

AU - Jones, M.

AU - Hammer, J.

AU - von Wulffen, M.

AU - Shah, A.

AU - Hoelz, H.

AU - Kutuyla, M.

AU - Burger, D.

AU - Martin, N.

AU - Gurusamy, S. R.

AU - Talley, N. J.

AU - Holtmann, G.

PY - 2017/8

Y1 - 2017/8

N2 - Background: The clinical assessments of patients with gastrointestinal symptoms can be time-consuming, and the symptoms captured during the consultation may be influenced by a variety of patient and non-patient factors. To facilitate standardized symptom assessment in the routine clinical setting, we developed the Structured Assessment of Gastrointestinal Symptom (SAGIS) instrument to precisely characterize symptoms in a routine clinical setting. Aims: We aimed to validate SAGIS including its reliability, construct and discriminant validity, and utility in the clinical setting. Methods: Development of the SAGIS consisted of initial interviews with patients referred for the diagnostic work-up of digestive symptoms and relevant complaints identified. The final instrument consisted of 22 items as well as questions on extra intestinal symptoms and was given to 1120 consecutive patients attending a gastroenterology clinic randomly split into derivation (n = 596) and validation datasets (n = 551). Discriminant validity along with test–retest reliability was assessed. The time taken to perform a clinical assessment with and without the SAGIS was recorded along with doctor satisfaction with this tool. Results: Exploratory factor analysis conducted on the derivation sample suggested five symptom constructs labeled as abdominal pain/discomfort (seven items), gastroesophageal reflux disease/regurgitation symptoms (four items), nausea/vomiting (three items), diarrhea/incontinence (five items), and difficult defecation and constipation (2 items). Confirmatory factor analysis conducted on the validation sample supported the initially developed five-factor measurement model ((Formula presented.), p < 0.0001, χ2/df = 4.6, CFI = 0.90, TLI = 0.88, RMSEA = 0.08). All symptom groups demonstrated differentiation between disease groups. The SAGIS was shown to be reliable over time and resulted in a 38% reduction of the time required for clinical assessment. Conclusions: The SAGIS instrument has excellent psychometric properties and supports the clinical assessment of and symptom-based categorization of patients with a wide spectrum of gastrointestinal symptoms.

AB - Background: The clinical assessments of patients with gastrointestinal symptoms can be time-consuming, and the symptoms captured during the consultation may be influenced by a variety of patient and non-patient factors. To facilitate standardized symptom assessment in the routine clinical setting, we developed the Structured Assessment of Gastrointestinal Symptom (SAGIS) instrument to precisely characterize symptoms in a routine clinical setting. Aims: We aimed to validate SAGIS including its reliability, construct and discriminant validity, and utility in the clinical setting. Methods: Development of the SAGIS consisted of initial interviews with patients referred for the diagnostic work-up of digestive symptoms and relevant complaints identified. The final instrument consisted of 22 items as well as questions on extra intestinal symptoms and was given to 1120 consecutive patients attending a gastroenterology clinic randomly split into derivation (n = 596) and validation datasets (n = 551). Discriminant validity along with test–retest reliability was assessed. The time taken to perform a clinical assessment with and without the SAGIS was recorded along with doctor satisfaction with this tool. Results: Exploratory factor analysis conducted on the derivation sample suggested five symptom constructs labeled as abdominal pain/discomfort (seven items), gastroesophageal reflux disease/regurgitation symptoms (four items), nausea/vomiting (three items), diarrhea/incontinence (five items), and difficult defecation and constipation (2 items). Confirmatory factor analysis conducted on the validation sample supported the initially developed five-factor measurement model ((Formula presented.), p < 0.0001, χ2/df = 4.6, CFI = 0.90, TLI = 0.88, RMSEA = 0.08). All symptom groups demonstrated differentiation between disease groups. The SAGIS was shown to be reliable over time and resulted in a 38% reduction of the time required for clinical assessment. Conclusions: The SAGIS instrument has excellent psychometric properties and supports the clinical assessment of and symptom-based categorization of patients with a wide spectrum of gastrointestinal symptoms.

KW - questionnaire development

KW - validation

KW - irritable bowel syndrome

KW - quality of life

KW - gastrointestinal symptoms

UR - http://www.scopus.com/inward/record.url?scp=85019770319&partnerID=8YFLogxK

U2 - 10.1007/s10620-017-4599-6

DO - 10.1007/s10620-017-4599-6

M3 - Article

VL - 62

SP - 1913

EP - 1922

JO - Digestive Diseases and Sciences

T2 - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

IS - 8

ER -