VALIDATION OF A NEW MEASURE OF DIARRHEA

Adequate measures of diarrheal disease are important to assess severit y for clinical use and outcomes research. We developed a questionnaire to assess diarrhea severity and complications, and administered it to 205 HIV positive patients with diarrhea, fever, or weight loss. Notew orthy variations in stool form were reported by individuals and across subjects. Self-reported diarrhea correlated with the occurrence of an y stool pictured without form. However, verbal descriptors ''loose'' a nd ''semiformed'' had little value in assessment of diarrheal disease. Both verbal and pictorial stool descriptors correlated well with diar rhea complications (pain, urgency, tenesmus, incontinence, and nocturn al diarrhea). By factor analysis, discomfort and nondiscomfort diarrhe a complications loaded on different factors, consistent with clinical experience that discomfort is a distinct problem in diarrheal disease. In summary we have developed an instrument to precisely characterize diarrhea severity that correlates well with clinically important event s such as incontinence and abdominal pain.