Table II.
PedsQL™ Gastrointestinal Symptoms Scales and Worry Scales Minimal Important Difference (MID) Scores and Cut-Points for Pediatric Patients With Gastrointestinal Disorders/Diseases and Healthy Sample Cut-Points
| Gastrointestinal Symptoms Scales and Worry Scales | Items | Gastrointestinal disorders/diseases |
Healthy controls |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| α | Mean (SD) | MID SEMa (95% CI) | % Cut-pointb ≥ 1 SD (95% CI) | % Cut-pointb ≥ 2 SD (95% CI) | α | Mean (SD) | Cut-pointc ≥ 1 SD | % Cut-pointb ≥1 SD (95% CI) | Cut-pointc ≥ 2 SD | % Cut-pointb ≥ 2 SD (95% CI) | ||
| Child self-report | N = 587 | N = 513 | ||||||||||
| Symptoms total scored | 58 | .96 | 72.5 (17.0) | 3.40 (1.93–4.87) | 51.9 (47.86– 55.94) | 27.7 (24.08– 31.32) | .98 | 88.6 (12.9) | 75.7 | 15.8* (12.64– 18.96) | 62.8 | 4.5* (2.71–6.29) |
| Stomach pain and hurt | 6 | .92 | 58.0 (25.5) | 7.21 (5.12–9.30) | 58.6 (54.62–62.58) | 27.8 (24.18–31.42) | .90 | 81.1 (17.8) | 63.3 | 19.7* (16.26–23.14) | 45.5 | 2.9* (1.45–4.35) |
| Stomach discomfort when eating | 5 | .90 | 74.0 (25.7) | 8.13 (5.92–10.34) | 39.7 (35.74–43.66) | 23.6 (20.16–27.04) | .90 | 89.6 (16.2) | 73.4 | 14.8* (11.73–17.87) | 57.2 | 6.6* (4.45–8.75) |
| Food and drink limits | 6 | .90 | 68.6 (27.0) | 8.54 (6.28–10.80) | 51.3 (47.26–55.34) | 30.6 (26.87–34.33) | .91 | 89.7 (17.0) | 72.7 | 14.6* (11.54–17.66) | 55.7 | 7.2* (4.96–9.44) |
| Trouble swallowing | 3 | .81 | 91.1 (16.1) | 7.02 (4.95–9.09) | 25.2 (21.69–28.71) | 11.5 (8.92–14.08) | .88 | 95.6 (10.9) | 84.7 | 13.8 (10.82–16.78) | 73.8 | 3.7 (2.07–5.33) |
| Heartburn and reflux | 4 | .72 | 78.8 (20.0) | 10.58 (8.09–13.07) | 43.5 (39.49–47.51) | 15.9 (12.94–18.86) | .78 | 90.6 (14.3) | 76.3 | 16.6* (13.38–19.82) | 62.0 | 5.3 (3.36–7.24) |
| Nausea and vomiting | 4 | .85 | 79.7 (22.5) | 8.71 (6.43–10.99) | 39.2 (35.25–43.15) | 17.8 (14.71–20.89) | .88 | 91.6 (14.7) | 76.9 | 16.2* (13.01–19.39) | 62.2 | 5.1 (3.20–7.00) |
| Gas and bloating | 7 | .90 | 64.3 (24.6) | 7.78 (5.61–9.95) | 43.5 (39.49–47.51) | 23.1 (19.69–26.51) | .93 | 83.3 (20.1) | 63.2 | 16.6* (13.38–19.82) | 43.1 | 5.1* (3.20–7.00) |
| Constipation | 14 | .94 | 71.1 (23.5) | 5.76 (3.88–7.64) | 42.6 (38.6–46.6) | 18.7 (15.55–21.85) | .96 | 86.9 (17.6) | 69.3 | 17.0* (13.75–20.25) | 51.7 | 4.3* (2.54–6.06) |
| Blood in poop | 2 | .89 | 85.9 (23.6) | 7.83 (5.66–10.0) | 29.9 (26.2–33.6) | 18.5 (15.36–21.64) | .87 | 96.3 (12.0) | 84.3 | 9.2* (6.70–11.70) | 72.3 | 4.3* (2.54–6.06) |
| Diarrhea | 7 | .89 | 78.5 (22.7) | 7.53 (5.40–9.66) | 47.7 (43.66–51.74) | 27.9 (24.27–31.53) | .91 | 94.3 (11.5) | 82.8 | 13.5* (10.54–16.46) | 71.3 | 4.9* (3.03–6.77) |
| Worry about going poop | 5 | .86 | 78.1 (25.4) | 9.50 (7.13–11.87) | 42.9 38.90–46.90) | 25.6 (22.07–29.13) | .85 | 94.2 (12.4) | 81.8 | 12.5* (9.64–15.36) | 69.4 | 4.5* (2.71–6.29) |
| Worry about stomach aches | 2 | .84 | 60.5 (32.8) | 13.12 (10.39–15.85) | 54.0 (49.97–58.03) | 47.3 (43.26–51.34) | .77 | 91.2 (16.4) | 74.8 | 10.9* (8.20–13.60) | 58.4 | 7.2* (4.96–9.44) |
| Parent proxy-report | N = 685 | N = 337 | ||||||||||
| Symptoms total scored | 58 | .97 | 70.0 (17.1) | 2.96 (1.69–4.23) | 63.0 (59.38–66.62) | 36.4 (32.80–40.00) | .98 | 90.0 (12.7) | 77.3 | 16.0* (12.09–19.91) | 64.6 | 6.8* (4.11–9.49) |
| Stomach pain and hurt | 6 | .95 | 54.2 (25.8) | 5.77 (4.02–7.52) | 60.3 (56.64–63.96) | 35.5 (31.92–39.08) | .94 | 80.7 (19.2) | 61.5 | 19.0* (14.81–23.19) | 42.3 | 4.5* (2.29–6.71) |
| Stomach discomfort when eating | 5 | .93 | 66.0 (26.8) | 7.09 (5.17–9.01) | 53.7 (49.97–57.43) | 30.0 (26.57–33.43) | .94 | 88.6 (17.7) | 70.9 | 17.2* (13.17–21.23) | 53.2 | 6.2* (3.63–8.77) |
| Food and drink limits | 6 | .95 | 68.2 (29.5) | 6.60 (4.74–8.46) | 56.3 (52.59–60.01) | 35.2 (31.62–38.78) | .92 | 91.0 (15.6) | 75.4 | 21.1* (16.74–25.46) | 59.8 | 7.7* (4.85–10.55) |
| Trouble swallowing | 3 | .89 | 92.2 (15.3) | 5.08 (3.44–6.72) | 22.6 (19.47–25.73) | 10.0 (7.75– 12.25) | .93 | 96.5 (11.3) | 85.2 | 9.5 (6.37–12.63) | 73.9 | 3.9 (1.83–5.97) |
| Heartburn and reflux | 4 | .81 | 80.8 (20.8) | 9.07 (6.92–11.22) | 37.6 (33.97–41.23) | 23.6 (20.42–26.78) | .80 | 93.3 (13.0) | 80.3 | 12.5* (8.97–16.03) | 67.3 | 5.3* (2.91–7.69) |
| Nausea and vomiting | 4 | .93 | 78.3 (24.9) | 6.59 (4.73–8.45) | 42.5 (38.80–46.20) | 24.7 (21.47–27.93) | .92 | 92.1 (15.2) | 76.9 | 15.7* (11.82–19.58) | 61.7 | 5.6* (3.15–8.05) |
| Gas and bloating | 7 | .93 | 62.9 (25.3) | 6.69 (4.82–8.56) | 57.9 (54.20–61.60) | 28.0 (24.64–31.36) | .94 | 86.9 (18.9) | 68.0 | 16.9* (12.90–20.90) | 49.1 | 5.9* (3.38–8.42) |
| Constipation | 14 | .95 | 66.5 (26.0) | 5.81 (4.06–7.56) | 55.2 (51.48–58.92) | 37.1 (33.48–40.72) | .96 | 89.3 (16.0) | 73.3 | 16.9* (12.90–20.90) | 57.3 | 6.2* (3.63–8.77) |
| Blood in poop | 2 | .94 | 84.5 (24.8) | 6.07 (4.28–7.86) | 32.0 (28.51–35.49) | 20.3 (17.29–23.31) | .92 | 96.3 (12.7) | 83.6 | 8.4* (5.44–11.36) | 70.9 | 4.2* (2.06–6.34) |
| Diarrhea | 7 | .90 | 77.4 (22.6) | 7.15 (5.22–9.08) | 51.8 (48.06–55.54) | 37.4 (33.78–41.02) | .92 | 94.8 (11.3) | 83.5 | 12.8* (9.23–16.37) | 72.2 | 5.9* (3.38–8.42) |
| Worry about going poop | 5 | .90 | 75.7 (26.0) | 8.22 (6.16–10.28) | 48.4 (44.66–52.14) | 35.5 (31.92–39.08) | .90 | 95.4 (11.9) | 83.5 | 8.3* (5.35–11.25) | 71.6 | 5.0* (2.67–7.33) |
| Worry about stomach aches | 2 | .86 | 60.0 (32.0) | 11.97 (9.54–14.40) | 67.7 (64.2–71.2) | 46.8 (43.06–50.54) | .79 | 92.8 (16.1) | 76.7 | 14.5* (10.74–18.26) | 60.6 | 5.9* (3.38–8.42) |
Note. Lower scores demonstrate more (worse) gastrointestinal symptoms and hence lower (worse) gastrointestinal-specific HRQOL.
*p < .001 for group differences. Bonferroni familywise correction for multiple comparisons, p = .0038.
aThe Standard Error of Measurement (SEM) was derived by multiplying the SD by the square root of 1-α. PedsQL™ scores in the column represent the transformed value of 1 SEM. For example, a 3.40 change in the Gastrointestinal Symptoms Total Score for patient self-report on the 0–100 scale represents an MID.
bDemonstrates the percentage of scores ≥1 or ≥2 SD below the healthy reference means. For example, 51.9% of patients self-reported Gastrointestinal Symptoms Total Scores ≥1 SD below the healthy reference mean. Significance levels indicate differences between patients versus healthy controls.
cScores ≥1 or ≥2 SD below the healthy reference means.
dSummary Score of the 10 Gastrointestinal Symptoms Scales scores.
α = Cronbach’s alpha internal consistency reliability; SD = standard deviation; MID = minimal important difference; CI = confidence interval.