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A simple tool to evaluate common disorders: validation of a "proctological symptom scale".

Kraemer M, Kara D, Rzepisko M, Sayfan J - Int J Colorectal Dis (2015)

Bottom Line: The PSS was found to significantly differentiate between proctological patients and controls.The intervention (one session of rubber band ligation in patients with haemorrhoidal disease) was reflected by a significantly improved overall PSS.The PSS may also be suitable for studies to measure and compare symptomatic improvement and success of different therapies in proctology.

View Article: PubMed Central - PubMed

Affiliation: Department of General and Visceral Surgery, Coloproctology, St. Barbara-Klinik, Hamm, Germany, mkraemer@barbaraklinik.de.

ABSTRACT

Purpose: Proctological symptomatology is of little complexity and therefore appears particularly suitable for comparative evaluation by visual scales. We devised a "proctological symptom scale" (PSS) with separate scales for four cardinal proctological symptoms: pain, itching/irritation, discharge/moisture, and bleeding. The objective of this study was to evaluate the PSS among proctological patients and non-proctological controls.

Methods: This was a single center non-interventional observational study on 229 proctological patients and 133 controls. The main outcome measures investigated were age- and sex-stratified comparison of the non-proctological cohort and the controls, effect of therapeutic intervention on scale values in a subset of patients with haemorrhoidal disease, and sensitivity of the PSS to detect therapeutic failure in this subset of patients.

Results: The PSS was found to significantly differentiate between proctological patients and controls. Gender and age had no significant influence on PSS values in the proctological cohort. The intervention (one session of rubber band ligation in patients with haemorrhoidal disease) was reflected by a significantly improved overall PSS. In 16 cases within this group, the PSS got worse. A case-by-case follow-up of these patients showed that 14 of the 16 patients ended up with surgery (or with the advice to have surgery).

Conclusions: The PSS reliably differentiates proctological patients from non-proctological controls. Following intervention, the PSS reliably differentiated therapeutic success from failure. We find the PSS to be a simple and useful tool in our clinical routine since it provides an easily obtainable and reproducible basis for the visit-by-visit assessment of proctological patients. The PSS may also be suitable for studies to measure and compare symptomatic improvement and success of different therapies in proctology.

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Related in: MedlinePlus

The proctological symptom scale
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Fig1: The proctological symptom scale

Mentions: The PSS therefore comprises four items: anal pain, anal itching/irritation, anal discharge/moisture, anal bleeding. Patients are asked to mark the severity they subjectively attribute to their symptom anywhere along the line on a 0 to 10 scale for each item separately (Fig. 1). To facilitate the use of the scale for both patient and clinician, we decided to mark the intervals from 0 to 10 and not use the classic visual analogue scale design without such markings. This scale enables the clinician to calculate the scale value without the use of a ruler. Scale markings in between whole numbers were rounded up or down to the nearest whole number. Markings halfway in between the numbers were rounded up.Fig. 1


A simple tool to evaluate common disorders: validation of a "proctological symptom scale".

Kraemer M, Kara D, Rzepisko M, Sayfan J - Int J Colorectal Dis (2015)

The proctological symptom scale
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4544484&req=5

Fig1: The proctological symptom scale
Mentions: The PSS therefore comprises four items: anal pain, anal itching/irritation, anal discharge/moisture, anal bleeding. Patients are asked to mark the severity they subjectively attribute to their symptom anywhere along the line on a 0 to 10 scale for each item separately (Fig. 1). To facilitate the use of the scale for both patient and clinician, we decided to mark the intervals from 0 to 10 and not use the classic visual analogue scale design without such markings. This scale enables the clinician to calculate the scale value without the use of a ruler. Scale markings in between whole numbers were rounded up or down to the nearest whole number. Markings halfway in between the numbers were rounded up.Fig. 1

Bottom Line: The PSS was found to significantly differentiate between proctological patients and controls.The intervention (one session of rubber band ligation in patients with haemorrhoidal disease) was reflected by a significantly improved overall PSS.The PSS may also be suitable for studies to measure and compare symptomatic improvement and success of different therapies in proctology.

View Article: PubMed Central - PubMed

Affiliation: Department of General and Visceral Surgery, Coloproctology, St. Barbara-Klinik, Hamm, Germany, mkraemer@barbaraklinik.de.

ABSTRACT

Purpose: Proctological symptomatology is of little complexity and therefore appears particularly suitable for comparative evaluation by visual scales. We devised a "proctological symptom scale" (PSS) with separate scales for four cardinal proctological symptoms: pain, itching/irritation, discharge/moisture, and bleeding. The objective of this study was to evaluate the PSS among proctological patients and non-proctological controls.

Methods: This was a single center non-interventional observational study on 229 proctological patients and 133 controls. The main outcome measures investigated were age- and sex-stratified comparison of the non-proctological cohort and the controls, effect of therapeutic intervention on scale values in a subset of patients with haemorrhoidal disease, and sensitivity of the PSS to detect therapeutic failure in this subset of patients.

Results: The PSS was found to significantly differentiate between proctological patients and controls. Gender and age had no significant influence on PSS values in the proctological cohort. The intervention (one session of rubber band ligation in patients with haemorrhoidal disease) was reflected by a significantly improved overall PSS. In 16 cases within this group, the PSS got worse. A case-by-case follow-up of these patients showed that 14 of the 16 patients ended up with surgery (or with the advice to have surgery).

Conclusions: The PSS reliably differentiates proctological patients from non-proctological controls. Following intervention, the PSS reliably differentiated therapeutic success from failure. We find the PSS to be a simple and useful tool in our clinical routine since it provides an easily obtainable and reproducible basis for the visit-by-visit assessment of proctological patients. The PSS may also be suitable for studies to measure and compare symptomatic improvement and success of different therapies in proctology.

Show MeSH
Related in: MedlinePlus