Innovative multidisciplinary tool for screening bowel and bladder symptoms in multiple sclerosis

Introduction: Bowel and bladder symptoms are frequent in people with Multiple Sclerosis (PwMS) and early diagnosis and treatment become crucial to improve their quality of life (QoL). The study aims to design a multidisciplinary questionnaire for screening bladder and bowel symptoms in PwMS.

Materials and methods: The Bowel and Bladder Symptoms Screening in Multiple Sclerosis (BBSS-MS) questionnaire for screening bowel and bladder symptoms was designed in Italian following a three-steps process. In the first step, a dedicated board of experts identified a pool of items, which will be analysed for content, clarity, and consistency during the second step. During the third step, the relevance of each item was evaluated through a two-round process following the Delphi method. For each round of the Delphi method, medians, the 25th and 75th percentiles, and the IQR of the score for each statement were calculated. Stata 16.1 software was used to conduct all analyses.

Results: The Board identified 22 items to include in the BBSS-MS, based on existing questionnaire and clinical expertise. After discussing about the comprehensibility and clarity of items, the first version of the BBSS-MS composed of 22 items was proposed. Following, a Panel of 44 experts scored the relevance of each question and all the questions reached the score to be included in the questionnaire. The final 21-item version of the BBSS-MS was proposed.

Discussion and conclusion: To our knowledge, the BBSS-MS represents the first self-reported hybrid questionnaire for screening bladder and bowel symptoms in an Italian MS population.