Multi-Dimensional Gastrointestinal Symptom Severity Index: Validation of a Brief GI Symptom Assessment Tool

Michael D. Crowell, Sarah B. Umar, Brian E. Lacy, Michael P. Jones, John K. DiBaise, Nicholas J. Talley

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Abstract: Few instruments have been developed and validated for the evaluation of multi-dimensional GI symptoms. The Gastrointestinal Symptoms Severity Index (GISSI), a multi-dimensional, self-report instrument, was designed as a brief measure of the frequency, severity, and bothersomeness of individual GI and pelvic floor/urogynecologic symptoms. Aim: To report the psychometric properties of the GISSI subscales, including factorial structure, validity, and internal consistency. Methods: The GISSI included 32 items that assessed upper and lower GI symptoms and seven items related to pelvic floor/urogynecologic symptoms. A total of 934 patients presenting for upper and lower GI complaints completed the questionnaire between January 2013 and December 2013. The sample was randomly split into derivation (n = 466) and validation datasets (n = 468). A non-patient sample of 200 was collected separately. Results: Exploratory factor analysis supported a six-factor model for the derivation sample that accounted for 69.3 % of the total variance. The six GI symptom clusters were labeled as constipation/difficult defecation (five items), abdominal pain/discomfort (four items), dyspepsia (four items), diarrhea/anal incontinence (four items), GERD/chest symptoms (four items), and nausea/vomiting (two items). Inclusion of additional items related to female pelvic floor/urogynecologic symptoms resulted in a separate factor. Confirmatory factor analysis of the validation dataset supported the a priori hypothesized six-factor measurement model (Χ<sup>2</sup>(428) = 1462.98; P < 0.001; GFI = .88; RMSEA = .051). Conclusion: The GISSI demonstrated good to excellent psychometric properties and provided multi-dimensional scaling of prominent GI symptom clusters. Further validation may provide an efficient, valid, and reliable measure of patient-reported clinical outcomes.

Original languageEnglish (US)
Pages (from-to)2270-2279
Number of pages10
JournalDigestive Diseases and Sciences
Volume60
Issue number8
DOIs
StatePublished - Aug 23 2015

Fingerprint

Pelvic Floor
Symptom Assessment
Psychometrics
Statistical Factor Analysis
Defecation
Dyspepsia
Constipation
Gastroesophageal Reflux
Self Report
Nausea
Abdominal Pain
Vomiting
Diarrhea
Thorax
Datasets

Keywords

  • Gastrointestinal symptoms
  • Gastrointestinal Symptoms Severity Index
  • Pelvic symptoms
  • Psychometrics
  • Urogynecologic symptoms

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Multi-Dimensional Gastrointestinal Symptom Severity Index : Validation of a Brief GI Symptom Assessment Tool. / Crowell, Michael D.; Umar, Sarah B.; Lacy, Brian E.; Jones, Michael P.; DiBaise, John K.; Talley, Nicholas J.

In: Digestive Diseases and Sciences, Vol. 60, No. 8, 23.08.2015, p. 2270-2279.

Research output: Contribution to journalArticle

Crowell, Michael D. ; Umar, Sarah B. ; Lacy, Brian E. ; Jones, Michael P. ; DiBaise, John K. ; Talley, Nicholas J. / Multi-Dimensional Gastrointestinal Symptom Severity Index : Validation of a Brief GI Symptom Assessment Tool. In: Digestive Diseases and Sciences. 2015 ; Vol. 60, No. 8. pp. 2270-2279.
@article{371edfc037f545efa496c5b00f69e76c,
title = "Multi-Dimensional Gastrointestinal Symptom Severity Index: Validation of a Brief GI Symptom Assessment Tool",
abstract = "Abstract: Few instruments have been developed and validated for the evaluation of multi-dimensional GI symptoms. The Gastrointestinal Symptoms Severity Index (GISSI), a multi-dimensional, self-report instrument, was designed as a brief measure of the frequency, severity, and bothersomeness of individual GI and pelvic floor/urogynecologic symptoms. Aim: To report the psychometric properties of the GISSI subscales, including factorial structure, validity, and internal consistency. Methods: The GISSI included 32 items that assessed upper and lower GI symptoms and seven items related to pelvic floor/urogynecologic symptoms. A total of 934 patients presenting for upper and lower GI complaints completed the questionnaire between January 2013 and December 2013. The sample was randomly split into derivation (n = 466) and validation datasets (n = 468). A non-patient sample of 200 was collected separately. Results: Exploratory factor analysis supported a six-factor model for the derivation sample that accounted for 69.3 {\%} of the total variance. The six GI symptom clusters were labeled as constipation/difficult defecation (five items), abdominal pain/discomfort (four items), dyspepsia (four items), diarrhea/anal incontinence (four items), GERD/chest symptoms (four items), and nausea/vomiting (two items). Inclusion of additional items related to female pelvic floor/urogynecologic symptoms resulted in a separate factor. Confirmatory factor analysis of the validation dataset supported the a priori hypothesized six-factor measurement model (Χ2(428) = 1462.98; P < 0.001; GFI = .88; RMSEA = .051). Conclusion: The GISSI demonstrated good to excellent psychometric properties and provided multi-dimensional scaling of prominent GI symptom clusters. Further validation may provide an efficient, valid, and reliable measure of patient-reported clinical outcomes.",
keywords = "Gastrointestinal symptoms, Gastrointestinal Symptoms Severity Index, Pelvic symptoms, Psychometrics, Urogynecologic symptoms",
author = "Crowell, {Michael D.} and Umar, {Sarah B.} and Lacy, {Brian E.} and Jones, {Michael P.} and DiBaise, {John K.} and Talley, {Nicholas J.}",
year = "2015",
month = "8",
day = "23",
doi = "10.1007/s10620-015-3647-3",
language = "English (US)",
volume = "60",
pages = "2270--2279",
journal = "Digestive Diseases and Sciences",
issn = "0163-2116",
publisher = "Springer New York",
number = "8",

}

TY - JOUR

T1 - Multi-Dimensional Gastrointestinal Symptom Severity Index

T2 - Validation of a Brief GI Symptom Assessment Tool

AU - Crowell, Michael D.

AU - Umar, Sarah B.

AU - Lacy, Brian E.

AU - Jones, Michael P.

AU - DiBaise, John K.

AU - Talley, Nicholas J.

PY - 2015/8/23

Y1 - 2015/8/23

N2 - Abstract: Few instruments have been developed and validated for the evaluation of multi-dimensional GI symptoms. The Gastrointestinal Symptoms Severity Index (GISSI), a multi-dimensional, self-report instrument, was designed as a brief measure of the frequency, severity, and bothersomeness of individual GI and pelvic floor/urogynecologic symptoms. Aim: To report the psychometric properties of the GISSI subscales, including factorial structure, validity, and internal consistency. Methods: The GISSI included 32 items that assessed upper and lower GI symptoms and seven items related to pelvic floor/urogynecologic symptoms. A total of 934 patients presenting for upper and lower GI complaints completed the questionnaire between January 2013 and December 2013. The sample was randomly split into derivation (n = 466) and validation datasets (n = 468). A non-patient sample of 200 was collected separately. Results: Exploratory factor analysis supported a six-factor model for the derivation sample that accounted for 69.3 % of the total variance. The six GI symptom clusters were labeled as constipation/difficult defecation (five items), abdominal pain/discomfort (four items), dyspepsia (four items), diarrhea/anal incontinence (four items), GERD/chest symptoms (four items), and nausea/vomiting (two items). Inclusion of additional items related to female pelvic floor/urogynecologic symptoms resulted in a separate factor. Confirmatory factor analysis of the validation dataset supported the a priori hypothesized six-factor measurement model (Χ2(428) = 1462.98; P < 0.001; GFI = .88; RMSEA = .051). Conclusion: The GISSI demonstrated good to excellent psychometric properties and provided multi-dimensional scaling of prominent GI symptom clusters. Further validation may provide an efficient, valid, and reliable measure of patient-reported clinical outcomes.

AB - Abstract: Few instruments have been developed and validated for the evaluation of multi-dimensional GI symptoms. The Gastrointestinal Symptoms Severity Index (GISSI), a multi-dimensional, self-report instrument, was designed as a brief measure of the frequency, severity, and bothersomeness of individual GI and pelvic floor/urogynecologic symptoms. Aim: To report the psychometric properties of the GISSI subscales, including factorial structure, validity, and internal consistency. Methods: The GISSI included 32 items that assessed upper and lower GI symptoms and seven items related to pelvic floor/urogynecologic symptoms. A total of 934 patients presenting for upper and lower GI complaints completed the questionnaire between January 2013 and December 2013. The sample was randomly split into derivation (n = 466) and validation datasets (n = 468). A non-patient sample of 200 was collected separately. Results: Exploratory factor analysis supported a six-factor model for the derivation sample that accounted for 69.3 % of the total variance. The six GI symptom clusters were labeled as constipation/difficult defecation (five items), abdominal pain/discomfort (four items), dyspepsia (four items), diarrhea/anal incontinence (four items), GERD/chest symptoms (four items), and nausea/vomiting (two items). Inclusion of additional items related to female pelvic floor/urogynecologic symptoms resulted in a separate factor. Confirmatory factor analysis of the validation dataset supported the a priori hypothesized six-factor measurement model (Χ2(428) = 1462.98; P < 0.001; GFI = .88; RMSEA = .051). Conclusion: The GISSI demonstrated good to excellent psychometric properties and provided multi-dimensional scaling of prominent GI symptom clusters. Further validation may provide an efficient, valid, and reliable measure of patient-reported clinical outcomes.

KW - Gastrointestinal symptoms

KW - Gastrointestinal Symptoms Severity Index

KW - Pelvic symptoms

KW - Psychometrics

KW - Urogynecologic symptoms

UR - http://www.scopus.com/inward/record.url?scp=84937517492&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937517492&partnerID=8YFLogxK

U2 - 10.1007/s10620-015-3647-3

DO - 10.1007/s10620-015-3647-3

M3 - Article

C2 - 25842355

AN - SCOPUS:84937517492

VL - 60

SP - 2270

EP - 2279

JO - Digestive Diseases and Sciences

JF - Digestive Diseases and Sciences

SN - 0163-2116

IS - 8

ER -