Evaluation of a Novel, Icon-Based Symptom Assessment Tool for Gastroenterology
Bibliographic record
Abstract
Introduction: Existing tools for evaluating gastrointestinal (GI) symptoms use verbal descriptors which are affected by social, cultural and linguistic factors. Furthermore, the perception of GI symptoms varies between individuals. Thus it is often difficult for patients to characterize their symptoms with terms, such as heartburn, nausea, bloating or abdominal cramps, making symptom monitoring imprecise. To address this, we are developing a GI symptom evaluation tool based on pictorial icons, designed from symptom descriptors identified by patient focus groups, which may allow patients and clinicians to better identify, record and monitor GI symptoms over time or in response to treatment. Methods: We aimed to assess the usability and responsiveness of a novel, icon-based symptom evaluation tool (Dhaliwal et al. Gut 2009;58(SII):A316; Dhaliwal et al. Gastroenterology 2012;140(5S1):S579). We evaluated this tool in comparison to a commonly-used, validated tool, the Gastrointestinal Symptom Rating Scale (GSRS), for assessing the severity of short-term GI symptoms triggered by mono- or disaccharides in patients undergoing outpatient breath hydrogen testing (BHT). Patients completed the iconbased tool and the GSRS, hourly, before and during a BHT performed for suspected bacterial overgrowth (glucose) or lactose/fructose intolerance. Results: Of 59 patients enrolled in the study, 8 were excluded for incomplete data. Breath tests were positive in 11 (21.6%) and negative in 40 (78.4%) patients. Increases in GI symptoms during the BHT were detected by the GSRS in 34 (66.7%) patients and by the icon-based tool in 30 (58.8%) patients. For the prediction of a positive BHT, the GSRS had a sensitivity of 81.8% and a specificity of 37.5% whilst the icon-based tool had a sensitivity of 72.7% and a specificity of 45%. The diagnostic odds ratio (dOR) of the icon-based tool was 2.18 (95% CI 0.43-12.3; p=0.49), the dOR of GSRS was 2.7 (95% CI 0.44-21; p=0.297). Conclusion: The icon-based symptom evaluation tool performs comparably to the validated GSRS with respect to the detection of acute, general GI symptoms triggered by the ingestion of a fermentable monosaccharide or disaccharide and to the prediction of a positive breath hydrogen test. Further development of the icon-based tool will require correlation of specific symptom-related icons with specific dietary and therapeutic interventions, disease mechanisms and sites of symptom generation with the goal of validating its use in clinical and research practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".