S520 Development and Validation of Brain Fog Questionnaire in Patients and Healthy Volunteers
Bibliographic record
Abstract
Introduction: Brain fogginess (BF) encompasses a constellation of neurocognitive symptoms that remain poorly characterized, in part due to its multidimensional symptoms. They are increasingly seen in gastroenterology patients, particularly those with gas, bloating and distension. We developed and psychometrically tested a 19-item questionnaire that described symptoms of importance to both patients and clinicians (Tetangco et al, ACG 2020). After due input from patients and clinicians, weightage analysis and item reduction, a 15-item new BF questionnaire (BFQ) was developed. Our aim here was to perform a preliminary comparative analysis of BFQ in patients with BF and healthy controls. Methods: In this Phase II questionnaire study, patients with unexplained abdominal gas, bloating, distension, and symptoms of BF for ≥3 months completed the 15-item BFQ using a visual analogue scale, and a 10-item Gas and Bloating validated questionnaire at baseline and 2-weeks. The patients also completed Montreal Cognitive Assessment (MoCA) and Digital Symbol Substitution test (DSST). Healthy controls were invited to complete the aforementioned questionnaires. Data were compared for test-retest reliability, and between the two groups. Results: Ten patients (8 females, mean age 44.4 years), and 12 healthy controls (5 females, mean age 42.8 years) participated. The most severe visual analogue scores for BF symptoms that were reported by patients included feeling sleepy (5.8±0.9), being easily distracted (5.8±1.0), and having difficulty focusing (5.5±0.9). The patients had a significantly higher BFQ total score compared to healthy controls (65.6±9.0 vs 9.8±4.1, p< 0.001), with all 15 BFQ items significantly higher than healthy controls on BFQ (Table). There was no significant difference in DSST scores (42.8±6.6 vs 61.5±17.6, p=0.065) or MoCA scores (25.6±0.9, vs 24.9±3.3, p=0.957) between the two groups. The BFQ had a good test-retest reliability (ICC=0.78, p=0.017) for 9/15 BFQ items. Conclusion: The 15-item BFQ comprehensively captures key symptoms of BF and significantly differentiates healthy controls from BF patients. Also, the lack of difference in MoCA and DSST scores between BF patients and healthy controls suggests that these patients do not have cognitive impairment. The BFQ has good test-retest reliability, but therapeutic responsiveness requires further study. Table 1. - Comparison of brain fog questionnaire responses in patients (baseline vs week 2), and healthy volunteers Brain Fog Questionnaire Patients HVs p value (Pts vs HVs) Baseline questionnaire 2-week questionnaire ICC p value I am forgetful and/or experience short-term memory loss 4.5±0.9 4.4±0.7 0.500 0.160 1.0±0.5 0.001 I have difficulty thinking 4.4±0.6 4.8±0.7 0.835 0.007 0.7±0.4 < 0.001 I have difficulty focusing 5.5±0.9 5.2±0.7 0.817 0.009 1.1±0.7 0.001 I feel cloudy and/or spacey 5.4±1.0 5.3±0.9 0.878 0.002 0.6±0.4 < 0.001 I have difficulty finding the right word(s) to communicate 3.8±0.9 3.6±0.6 0.665 0.059 0.6±0.3 0.003 I have difficulty understanding what others say 2.8±0.6 3.0±0.7 0.364 0.255 0.2±0.1 0.001 I feel mentally fatigued and/or exhausted 5.3±1.0 5.0±1.0 0.764 0.021 0.9±0.3 < 0.001 I feel that I am slow 3.6±0.9 3.5±0.8 0.784 0.016 0.6±0.4 0.009 My mind goes blank 4.4±0.9 4.2±0.9 0.170 0.393 0.9±0.5 0.003 I am easily distracted 5.8±1.0 4.9±0.9 0.853 0.004 1.3±0.7 0.002 I have difficulty understanding words that I have read 3.5±0.9 2.6±0.7 0.872 0.003 0.2±0.1 0.003 I experience confusion 4.0±1.1 3.9±0.9 0.882 0.002 0.2±0.1 0.001 I feel sleepy 5.8±1.0 5.4±0.8 0.747 0.027 0.8±0.3 < 0.001 I feel that my thoughts are moving too quickly 3.3±0.9 3.6±1.0 0.463 0.184 0.2±0.2 0.001 I go somewhere to do something, but cannot remember why 3.8±0.9 4.4±1.0 0.272 0.321 0.7±0.3 0.004 BFQ total score 65.6±9.0 63.7±8.1 0.779 0.017 9.8±4.2 < 0.001
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".