Physician-Patient Discordance in Bristol Stool Scale Classification and Overall IBS Burden Assessment.

In 30 seconds

This post hoc analysis of a randomized trial compared patient-reported and physician-assessed Bristol Stool Form Scale (BSFS) classifications in people with irritable bowel syndrome (IBS), alongside symptom severity and quality-of-life measures. Agreement was poor on both the seven-point scale (κ = -0.01, P = 0.77) and after grouping scores into three categories (κ = 0.04, P = 0.46). The classifications matched in only 18/64 cases (28%). Symptom severity and quality-of-life scores were similar in concordant and discordant groups.

Key findings

• Patient and physician BSFS classifications agreed in only 18/64 cases (28%).
• Agreement was poor on the seven-point scale (κ = -0.01, P = 0.77) and three-category scale (κ = 0.04, P = 0.46).
• Symptom severity and quality-of-life scores were similar between concordant and discordant groups.

Why it matters

The BSFS is commonly used to describe stool consistency and classify IBS subtypes, but this analysis found substantial disagreement between patient and physician assessments. The results highlight that a stool-form score alone may not capture a consistent account of stool consistency or overall IBS burden, an important consideration when interpreting assessments.

What to keep in mind

This was a post hoc analysis, and the abstract does not provide further details on the study population or assessment procedures.