The Waiting Room Questionnaire, a Patient-Reported Outcome Instrument Including Pictograms for Facilitating the Diagnosis of Functional Gastrointestinal Disorders.

Introduction: Disorders of gut-brain interaction (DGBI) are a heterogeneous group of chronic conditions without a known organic etiology, with a significant socio-economic impact. In clinical practice, challenges remain in accurately assessing DGBI symptoms. Accurate interpretation and communication of the symptom pattern are imperative for a correct diagnosis. Hence, our group recently developed a Rome criteria-based Waiting Room Questionnaire (WRQ) with pictograms for visual support to improve symptom identification. This cross-sectional study aims to validate the WRQ for symptom assessment and DGBI diagnosis.

Methods: In a tertiary care multicentric study, 245 ambulatory patients (71% female, 41 ± 19.4 years old) completed the WRQ. The clarity and added value were recorded by the patients. The concordance between diagnosis based on the WRQ most bothersome symptom and the expert clinician's diagnosis were compared.

Results: Based on the expert opinion of clinicians, 53 patients were primarily diagnosed with gastro-esophageal reflux disease (GERD), 66 with postprandial distress syndrome (PDS), 36 with epigastric pain syndrome (EPS), 57 with irritable bowel syndrome (IBS) and 26 with chronic nausea/vomiting syndrome (CNVS). Pictograms entailed an added value according to 88% of the patients, and 95% of the patients understood all questions. Overall, patients' answers on the WRQ were highly reliable. Inter-rater agreement was substantial (Cohen's kappa = 0.72) with an overall concordance of 78% between expert opinion and the most bothersome symptom reported on the WRQ.

Conclusion: The WRQ is a comprehensive and reliable tool facilitating the diagnosis of patients with DGBI.