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Neurogenic Bowel Dysfunction Score (NBDS)
Neurogenic Bowel Dysfunction Score (NBDS)
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Supplemental - Highly Recommended: Spinal cord Injury (SCI)*
*Recommendation of Use: To assess bowel characteristics, methods of management, and symptoms of complications such as incontinence, constipation and impact on QOL. (Tate et al., 2020)
|Short Description of Instrument||
The Neurogenic Bowel Dysfunction Score (NBDS) is a self-report questionnaire that evaluates the individual's degree of neurogenic bowel dysfunction (NBD) symptomatology. (Krogh et al., 2006) It was developed to evaluate the severity of colorectal dysfunction clinically in patients with SCI.
|Scoring and Psychometric Properties||
The NBD score is a 10-item questionnaire that is associated with impaired QoL caused by bowel symptoms, including frequency of defecation (0-6 points), time used for each defecation (0-7 points), uneasiness or headache or perspiration during defecation (0-2 points), regular use of tablets against constipation (0-2 points), regular use of drops against constipation (0-2 points), digital stimulation or evacuation of the anorectum (0-6 points), frequency of fecal incontinence (0-13 points), medication against fecal incontinence (0-4 points), flatus incontinence (0-2 points) and perianal skin problems (0-3 points).
The 10-items are scored on an ordinal scale. One additional question regarding general satisfaction, is not included in the total score.
The NBD weighted score ranges between 0 and 47 points. A higher overall NBD score indicates more severe bowel symptoms.
The NBD severity level is divided into four subgroups based on the scores (Krogh et al., 2006; Bournet-Blanquart et al., 1990; Menardo et al., 1987; Krogh et al., 2000; MacDonagh et al., 1992; Liu et al., 2000; Agachan et al, 1996):
Score 0-6: Very minor
Score 7-9: Minor
Score 10-13: Moderate
Score 14+: Severe
Reliability: Test-retest and interrater reliability of the selected items good (Krogh et al., 2006; Erdem et al., 2017)
Validity: High internal consistency (Krogh et al., 2006; Erdem et al., 2017; Mallek et al., 2016) Correlation was 0.91 between NBD and physician's global assessment (Krogh et al., 2006) Correlation was 0.92 between NBDS and impact of NBD on QoL (Erdem et al., 2017)
Responsiveness: Correlation 0.82 between change NBDS and global rating of change. Erdem et al., 2017) Four SCI trials showed significant change of NBDS scores. (Christensen et al., 2006)
Strengths/Weaknesses: The NBDS is widely used in SCI and provides an assessment of the impact of symptoms on quality of life. (Tate et al., 2020). Future studies will establish minimal detectable change, minimal clinically important difference as well translations in other languages.
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Document last updated November 2021