The following is the summary of “Development and Validation of a Symptom-Based Scoring System for Bowel Dysfunction After Ileoanal Pouch Reconstruction: The Ileoanal Pouch Syndrome Severity Score” published in January 2023 issue of Diseases of the Colon & Rectum by Cavallaro, et al.


About 7 symptoms and 7 consequences were recognized by the Patient-Reported Outcomes After Pouch Surgery Delphi Consensus Study as important domains for assessing and interpreting ileoanal pouch function. The purpose of this research was to develop a validated instrument for evaluating pouch function by using questions prioritized by the Patient-Reported Outcomes After Pouch Surgery Delphi Consensus Study. Patients were given a questionnaire to fill up, which asked how often they had several different gastrointestinal symptoms. Patients with pouches were enrolled at inflammatory bowel disease facilities and through patient advocacy websites.

Principal Outcome Measures Logistic regression modeling was used to determine associations between items and quality of life in a score-generating cohort of 298 patients. Point values were assigned to categories to generate a cumulative score called the Ileoanal Pouch Syndrome Severity Score. The area under the receiver operating characteristic curve was used to assess validity in a second cohort of 386 patients. Additionally, convergent validity, clinical validity, and test-retest validity were assessed. After calculating the relative importance of each scaled item, the resulting score range was found to be between 0 and 145. Cutoff values for the diagnosis of “ileoanal pouch syndrome” based on score ranges were then established. 

The score was subsequently confirmed on a second set of patients, yielding an area under the curve for the receiver operating characteristic of 0.83. Importantly, there was a strong correlation between a higher Ileoanal Pouch Syndrome Score and a poorer quality of life. Test-retest validity, convergent validity with other bowel function scores, and clinical validity were also demonstrated for the questionnaire.  A patient-centered, clinically effective scoring system was created in this study to measure the spectrum and intensity of symptoms reported by people with ileoanal pouches and its association with quality of life.

Source: journals.lww.com/dcrjournal/Abstract/2023/01000/Development_and_Validation_of_a_Symptom_Based.12.aspx