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J Clin Med. 2017 Nov 4;6(11). pii: E105. doi: 10.3390/jcm6110105.

Inter-Rater Reliability of Provider Interpretations of Irritable Bowel Syndrome Food and Symptom Journals.

Author information

1
Division of Gastroenterology and Hepatology, Department of Medicine, University of Washington, Seattle, WA 98195, USA. JZia@medicine.washington.edu.
2
Department of Human Centered Design and Engineering, University of Washington, Seattle, WA 98195, USA. cfchung@uw.edu.
3
Department of Human Centered Design and Engineering, University of Washington, Seattle, WA 98195, USA. xky1231@uw.edu.
4
Department of Human Centered Design and Engineering, University of Washington, Seattle, WA 98195, USA. dyellen@uw.edu.
5
Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA. jschenk@fredhutch.org.
6
Department of Biostatistics and Office of Nursing Research, University of Washington, Seattle, WA 98195, USA. cain@uw.edu.
7
Department of Human Centered Design and Engineering, University of Washington, Seattle, WA 98195, USA. smunson@uw.edu.
8
Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA 98195, USA. heit@uw.edu.

Abstract

There are currently no standardized methods for identifying trigger food(s) from irritable bowel syndrome (IBS) food and symptom journals. The primary aim of this study was to assess the inter-rater reliability of providers' interpretations of IBS journals. A second aim was to describe whether these interpretations varied for each patient. Eight providers reviewed 17 IBS journals and rated how likely key food groups (fermentable oligo-di-monosaccharides and polyols, high-calorie, gluten, caffeine, high-fiber) were to trigger IBS symptoms for each patient. Agreement of trigger food ratings was calculated using Krippendorff's α-reliability estimate. Providers were also asked to write down recommendations they would give to each patient. Estimates of agreement of trigger food likelihood ratings were poor (average α = 0.07). Most providers gave similar trigger food likelihood ratings for over half the food groups. Four providers gave the exact same written recommendation(s) (range 3-7) to over half the patients. Inter-rater reliability of provider interpretations of IBS food and symptom journals was poor. Providers favored certain trigger food likelihood ratings and written recommendations. This supports the need for a more standardized method for interpreting these journals and/or more rigorous techniques to accurately identify personalized IBS food triggers.

KEYWORDS:

diet; irritable bowel syndrome; journaling; self-management

Conflict of interest statement

The authors declare no conflict of interest. The founding sponsors had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript or in the decision to publish the results.

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