Abstract
This paper describes the development and testing of a new self-report measure, the Dyspepsia Symptom Severity Index (DSSI), for assessing the severity of symptoms commonly associated with dyspepsia. The instrument was based on the literature, focus groups, and feedback from gastroenterologists; 48 patients and 24 controls participated in testing. Patients completed the DSSI and a symptom diary to test concurrent validity; one-week reproducibility was evaluated in 21 stable patients. Three subscales comprise the 20-item DSSI, representing reflux-, ulcer-, and dysmotility-like symptoms. Subscale internal consistency levels (α) were high (0.84–0.89), total score α levels were very good (0.76, 0.80), and scores were reproducible (ICC = 0.90–0.92). Correlations between the DSSI and diary were moderate to strong (r = 0.33–0.77; P < 0.05). Patients reported significantly more severe symptoms than controls (P < 0.001). Results indicate the DSSI is a reliable and valid tool for evaluating symptom severity in patients with functional dyspepsia.
Similar content being viewed by others
REFERENCES
Talley NJ, Colin-Jones D, Koch KL, Koch M, Nyren O, Stanghellini V: Functional dyspepsia: A classification with guidelines for diagnosis and management. Gastroenterology Int 4:145–160, 1991
Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ 3rd: Dyspepsia and dyspepsia subgroups: A population-based study. Gastroenterology 102:1259–1268, 1992
Heading RC: Definitions of dyspepsia. Scand J Gastroenterol 26(suppl 182):1–6, 1991
Colin-Jones DG: Management of dyspepsia: Report of a working party. Lancet 1(8585):576–579, 1988
Chiba N: Definitions of dyspepsia: Time for a reappraisal. Eur J Surg Suppl 583:14–23, 1998
Grainger SL, Klass HJ, Rake MO, Williams JG: Prevalence of dyspepsia: The epidemiology of overlapping symptoms. Postgrad Med J 70:154–161, 1994
Jebbink HJ, Smout AJ, van Berge Henegouwen GP: Ranitidine therapeutically effective in functional dyspepsia with re-flux-like symptoms. Ned Tijdschr Geneeskd 137(35):1772–1775, 1993
Buckley MJ, Scanlon C, McGurgan P, O'Morain CA: A validated dyspepsia symptom score. Ital J Gastroenterol Hepatol 29:495–500, 1997
Knill-Jones RP: Geographical differences in the prevalence of dyspepsia. Scand J Gastroenterol 26(suppl 182):17–24, 1991
Stanghellini V, Tosetti C, Paternico A, Barbara G, Morselli-Labate AM, Monetti N, Marengo M, Corinaldesi R: Risk indicators of delayed gastric emptying of solids in patients with functional dyspepsia. Gastroenterology 110:1036–1042, 1996
Agreus L, Talley N: Dyspepsia: Current understanding and management. Annu Rev Med 49:475–493, 1998
Holtmann G, Stanghellini V, Talley NJ: Nomenclature of dyspepsia, dyspepsia subgroups and functional dyspepsia: Clarifying the concepts. Baillieres Clin Gastroenterol 12(3):417–433, 1998
Agreus L: The epidemiology of functional gastrointestinal disorders. Eur J Surg Suppl 583:60–66, 1998
Cutts TF, Abell TL, Karas JG, Kuns J: Symptom improvement from prokinetic therapy corresponds to improved quality of life in patients with severe dyspepsia. Dig Dis Sci 41:1369–1378, 1996
Veldhuyzen van Zanten SJ, Tytgat MAJ, Pollak PT, Goldie J, Goodacre RL, Riddell RH, Hunt RH: Can severity of symptoms be used as an outcome measure in trials of non-ulcer dyspepsia and Helicobacter-pylori associated gastritis? J Clin Epidemiol 46:273–279, 1993
Veldhuyzen van Zanten SJ, Tytgat KM, Jalali S, Goodacre RL, Hunt RH: Can gastritis symptoms be evaluated in clinical trials? An overview of treatment of gastritis, nonulcer dyspepsia and campylobacter-associated gastritis. J Clin Gastroenterol 11:496–501, 1989
Adang RP, Ambergen AW, Talmon JL, Hasman A, Vismans JF, Stockbrugger RW: The discriminative value of patient characteristics and dyspeptic symptoms for upper gastrointestinal endoscopic findings: A study on the clinical presentation of 1,147 patients. Digestion 57(2):118–134, 1996
Penston J, Pounder R: A survey of dyspepsia in Great Britain. Aliment Pharmacol Ther 10:83–89, 1996
Talley NJ, Fett SL, Zinsmeister AR, Melton LJ 3rd: Gastrointestinal tract symptoms and self-reported abuse: A population-based study. Gastroenterology 107(4):1040–1049, 1994
Talley NJ, Phillips SF, Wiltgen CM, Zinsmeister AR, Melton LJ 3rd: Assessment of functional gastrointestinal disease: The bowel disease questionnaire. Mayo Clin Proc 65:1456–1479, 1990
Talley NJ, Phillips SF, Melton J 3rd, Wiltgen C, Zinsmeister AR: A patient questionnaire to identify bowel disease. Ann Intern Med 111:671–674, 1989
Talley NJ, Shuter B, McCrudden G, Jones M, Hoschl R, Piper DW: Lack of association between gastric emptying of solids and symptoms in nonulcer dyspepsia. J Clin Gastroenterol 11(6):625–630, 1989
Cook KF, Rabeneck L, Campbell CJM, Wray NP: Evaluation of a multidimensional measure of dyspepsia-related health for use in a randomized clinical trial. J Clin Epidemiol; 52(5):381–392, 1999
El-Omar EM, Banerjee S, Wirz A, McColl KE: The Glasgow Dyspepsia Severity Score—a tool for the global measurement of dyspepsia. Euro J Gastroenterol Hepatol 8:967–971, 1996
Wiklund IK, Junghard O, Grace E, Talley NJ, Kamm M, Veldhuyzen van Zanten S, Pare P, Chiba N, Leddin DS, Bigard M-A, Colin R, Schoenfeld P: Quality of life in reflux and dyspepsia patients. Psychometric documentation of a new disease-specific questionnaire (QOLRAD). Eur J Surg 164(suppl 583):41–49, 1998
Haug TT, Wilhelmsen I, Ursin H, Berstad A: What are the real problems for patients with functional dyspepsia? Scand J Gastroenterol 30:97–100, 1995
Schubert TT, Schubert AB, Ma CK: Symptoms, gastritis, and Helicobacter pylori in patients referred for endoscopy. Gastrointest Endosc 38(3):357–360, 1992
Nagler J, Miskovitz P: Clinical evaluation of domperidone in the treatment of chronic postprandial idiopathic upper gastrointestinal distress. Am J Gastroenterol 76(6):495–499, 1981
Marzio L, DiFelice F, Laico MG, Imbimbo B, Lapenna D, Cuccurullo F: Gallbladder hypokinesia and normal gastric emptying of liquids in patients with dyspeptic symptoms. A double-blind placebo-controlled clinical trial with cisapride. Dig Dis Sci 37(2):262–267, 1992
van Wijk HJ, Smout AJ, Akkermans LM, Roelofs JM, ten Thije OJ: Gastric emptying and dyspeptic symptoms in the irritable bowel syndrome. Scand J Gastroenterol 27(2):99–102, 1992
Czinn SJ, Bertram TA, Murray PD, Yang P: Relationship between gastric inflammatory response and symptoms in patients infected with Helicobacter pylori. Scand J Gastroenterol Suppl 181:33–37, 1991
Rosch W: Efficacy of cisapride in the treatment of epigastric pain and concomitant symptoms in non-ulcer dyspepsia. Scand J Gastroenterol 24(suppl 165):54–58, 1989
Shah S, Dalal N: Clinical evaluation of domperidone in gastric motility disorders (R 33 812). Curr Med Prac 32(1):9–12, 1988
Testoni PA, Bagnolo F, Fanti L, Passaretti S, Tittobello A: Long-term oral cisapride improves interdigestive antroduodenal motility in dyspeptic patients. Gut 31:288–290, 1990
Hendrix R, Van Lint J: Experience with cisapride in the treatment of chronic functional dyspepsia. Prog Med 43(suppl 1):69–75, 1987
Verhaegen H, DeCree J, Leempoels J: Treatment of chronic dyspepsia with cisapride and domperidone. Acta Ther 13:385–394, 1987
Talley NJ, Weaver AL, Zinsmeister AR: Impact of functional dyspepsia on quality of life. Dig Dis Sci 40(3):584–589, 1995
Abell TL, Cutts TF, Cooper T: Effect of cisapride therapy for severe dyspepsia on gastrointestinal symptoms and quality of life. Scand J Gastroenterol Suppl 195:60–63, discussion 63–64, 1993
Corinaldesi R, Stanghellini V, Raiti C, Rea E, Salgemini R, Barbara L: Effect of chronic administration of cisapride on gastric emptying of a solid meal and on dyspeptic symptoms in patients with idiopathic gastroparesis. Gut 28(3):300–305, 1987
Nandurkar S, Talley NJ, Xia H, Mitchell H, Hazel S, Jones M: Dyspepsia in the community is linked to smoking and aspirin use but not to Helicobacter pylori infection. Arch Intern Med 158:1427–1433, 1998
Verdu E, Fraser R, Tiberio D, Herranz M, Sipponen P, Blum L, Michetti P: Prevalence of Helicobacter pylori infection and chronic dyspeptic symptoms among immigrants from developing countries and people born in industrialized countries. Digestion 57:180–185, 1996
Davis RH, Clench MH, Mathias JR: Effects of domperidone in patients with chronic unexplained upper gastrointestinal symptoms: A double-blind, placebo-controlled study. Dig Dis Sci 33(12):1505–1511, 1988
Small PK, Loudon MA, Waldron B, Smith D, Campbell FC: Importance of reflux symptoms in functional dyspepsia. Gut 36(2):189–192, 1995
Kuykendall DH, Rabeneck L, Campbell CJM, Wray NP: Dyspepsia: How should we measure it? J Clin Epidemiol 51(2):99–106, 1998
Garratt AM, Ruta DA, Russell I, Macleod K, Brunt P, Mc-Kinlay A, Mowat A, Sinclair T: Developing a condition-specific measure of health for patients with dyspepsia and ulcer-related symptoms. J Clin Epidemiol 49(5):565–571, 1996
Koch KL, Bingaman S: Gastric electrical activity, gastric emptying, and the water load test in evaluating patients with functional dyspepsia. Am J Gastroenterol 3:1642, 1998 (Abstract)
Nunnally JC, Bernstein IH: Psychometric Theory. 3rd ed. New York, McGraw-Hill, 1994
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Leidy, N.K., Farup, C., Rentz, A.M. et al. Patient-Based Assessment in Dyspepsia:. Dig Dis Sci 45, 1172–1179 (2000). https://doi.org/10.1023/A:1005558204440
Issue Date:
DOI: https://doi.org/10.1023/A:1005558204440