Skip to main content
Log in

Validation of Irritable Bowel Syndrome Global Improvement Scale: An Integrated Symptom End Point for Assessing Treatment Efficacy

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The Global Improvement Scale (GIS) assesses multiple irritable bowel syndrome (IBS) symptoms using a patient-defined 7-point Likert scale ranging from symptoms substantially worse to substantially improved. To evaluate the scale as an efficacy end point, data were collected from two 12-week randomized, double-blind, placebo-controlled studies of female nonconstipated IBS patients. GIS responders were defined as having substantial or moderate improvement in IBS symptoms. GIS responders had more days with satisfactory control of urgency, firmer stools, fewer stools per day, and fewer days with incomplete evacuation compared to nonresponders. Substantially more GIS responders (90% and 89% in studies 1 and 2, respectively) were satisfied or very satisfied with their treatment overall compared to nonresponders (13% and 11%) ( r = 0.8 in both studies). GIS responders had greater satisfaction with medication relief of pain and discomfort and the time needed to return to usual activities. Favorable correlations between GIS and work and nonwork productivity losses were observed. Correlation of the GIS measure with IBS clinical end points establishes the validity of the GIS for measuring improvement in IBS symptoms. The GIS may be useful in assessing the efficacy of IBS interventions in future clinical trials.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Russo MW, Gaynes BN, Drossman DA: A national survey of practice patterns of gastroenterologists with comparison to the past two decades. J Clin Gastroenterol 29(4):339-343, 1999

    Google Scholar 

  2. Thompson WG, Heaton KW, Smyth GT, Smyth C: Irritable bowel syndrome in general practice: prevalence, characteristics, and referral. Gut 46(1):78-82, 2000

    Google Scholar 

  3. Everhart J, Renault P: Irritable bowel syndrome in office-based practice in the United States. Gastroenterology 100:998-1003, 1991

    Google Scholar 

  4. Northcutt A, Harding J, Kong S, Hamm T, Perschy T, Heath A, Dukes G, McSorley D, Mangel A: Urgency as an endpoint in IBS. Gastroenterology 116:A1036, 1999

    Google Scholar 

  5. American Gastroenterological Association: The Burden of Gastrointestinal Diseases. http://www.gastro.org/pdf/burden-report.pdf. 2001

  6. Thompson WG: Irritable bowel syndrome: a management strategy. Baillieres Best Pract Res Clin Gastroenterol 13(3):453-460, 1999

    Google Scholar 

  7. Camilleri M: Management of the irritable bowel syndrome. Gastroenterology 120(3 special issue):652-668, 2001

    Google Scholar 

  8. Spiller RC: Problems and challenges in the design of irritable bowel syndrome clinical trials: experience from published trials. Am J Med 107(5A):91S-97S, 1999

    Google Scholar 

  9. Veldhuyzen van Zanten SJ, Talley NJ, Bytzer P, Klein KB, Whorwell PJ, Zinsmeister AR: Design of treatment trials for functional gastrointestinal disorders. Gut 45(suppl 2):II69-II77, 1999

    Google Scholar 

  10. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA: Functional bowel disorders and functional abdominal pain. Gut 45(suppl 2):II43-II47, 1999

    Google Scholar 

  11. Lembo T, Wright RA, Bagby B, Decker C, Gordon S, Jhingran P, Carter E: Alosetron controls bowel urgency and provides global symptom improvement in women with diarrhea-predominant irritable bowel syndrome. Am J Gastroenterol 96(9):2662-2670, 2001

    Google Scholar 

  12. Harding JP, Hamm LR, Ehsanullah R, Heath AT, Sorrells SC, Haw J, Dukes GE, Wolfe SG, Mangel AW, Northcutt AR: Use of a novel electronic data collection system in multicenter studies of irritable bowel syndrome. Aliment Pharmacol Ther 11(6):1073-1076, 1997

    Google Scholar 

  13. Hollander M, Wolfe D: Nonparametric Statistical Methods. New York, John Wiley & Sons, 1973

    Google Scholar 

  14. Gralnek I, Hays R, Kilbourne A, Naliboff B, Mayer E: The impact of IBS on health-related quality of life. Gastroenterology 119:654-660, 2000

    Google Scholar 

  15. Corney R, Stanton R: Physical symptom severity, psychological and social dysfunction in a series of outpatients with irritable bowel syndrome. J Psychosom Res 34:483-491, 1990

    Google Scholar 

  16. Hahn BA, Kirchdoerfer LJ, Fullerton S, Mayer E: Patient-perceived severity of irritable bowel syndrome in relation to symptoms, health resource utilization and quality of life. Aliment Pharmacol Ther 11(3):553-559, 1997

    Google Scholar 

  17. Jaeschje R, SInger J, Guyatt G: A comparison of seven-point and visual analog sclaes. Control Clin Trials 11:43-51, 1990

    Google Scholar 

  18. Klein K: Controlled treatment trials in the irritable bowel syndrome: a critique. Gastroenterology 95(1):232-241, 1988

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gordon, S., Ameen, V., Bagby, B. et al. Validation of Irritable Bowel Syndrome Global Improvement Scale: An Integrated Symptom End Point for Assessing Treatment Efficacy. Dig Dis Sci 48, 1317–1323 (2003). https://doi.org/10.1023/A:1024159226274

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1024159226274

Navigation