The daily diary and the questionnaire are not equivalent for the evaluation of bowel habits

Received 22 October 2008; accepted 14 April 2009. published online 27 May 2009.

Abstract

Background

It is unclear whether questionnaires and diary cards, which are widely used to collect data on bowel habits, provide analogous information.

Aims

We verified the concordance between the data provided by a daily diary and a retrospective questionnaire.

Methods

A 4-week diary (DIARY) concerning bowel habits was compiled by 221 subjects. They were also asked to fill out a questionnaire on their bowel habits before (BEF) and after (AFT) the diary period.

Results

Concerning bowel movements, no significant difference was detected in the concordance between BEF and DIARY (ρ: 0.80), AFT and DIARY (ρ: 0.84), or BEF and AFT (ρ: 0.84).

The mean concordance in the other defecation-related parameters between BEF and DIARY (K: 0.62) and between DIARY and AFT (K: 0.63) were both significantly lower than that seen between BEF and AFT (K: 0.80; p<0.01).

Conclusion

A considerable discrepancy between the two methods of assessment was found. The higher concordance between BEF and AFT than between DIARY and AFT regarding defecation-related parameters suggests that when a subject recalls events, even those from the recent past, he/she tends to generalize, reporting more or less the same data for different periods of time. These two instruments cannot be viewed as interchangeable, and their inherent differences must be taken into account when deciding which one to employ in different settings.

Keywords: Bowel habits, Diary card, Questionnaire

a Gastrointestinal Unit, Department of Gastroenterology, University of Pisa, Via Paradisa 2, 56126 Pisa, Italy

b Gastroenterology and Digestive Endoscopy Unit, “A. Cardarelli” Hospital, Naples, Italy

c Biostatistics Unit, Department of Health Sciences (DISSAL), University of Genoa, Italy

d Gastroenterology and Digestive Endoscopic Unit, Asti, Italy

e Polyspecialistic Medicine Unit, Cesena, Italy

f Gastroenterology and Digestive Endoscopy Unit, Massa, Italy

g Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Italy

h National Cancer Research Institute, Genoa, Italy

i Department of Medical and Surgical Critical Care, University of Florence, Italy

Corresponding author. Tel.: +39 050 997394; fax: +39 050 997398.

1 The following members of the Italian Constipation Study Group participated in the study: M. Bellini, S. Biagi, F. Costa, N. De Bortoli, D. Gambaccini, C. Mammini, M.G. Mumolo, A. Ricchiuti, S. Marchi (Pisa); A. Bove, A. Balzano (Naples); M.P. Sormani, P. Bruzzi (Genoa); E. Battaglia, P. Niola, C. Verna, M. Grassini (Asti); R. Bocchini, M. Cimatti, L. Fornasari, I. Montaletti, P. Pazzi (Cesena/Forlì); P. Alduini, I. Berni, G. Ceccarelli (Massa); G. Bassotti, N. Corazzi, B. Morozzi, L.Barreto Neto Viegas (Perugia); F. Pucciani, I. Giani, N. Ringressi (Firenze).

PII: S1590-8658(09)00205-9

doi:10.1016/j.dld.2009.04.008

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