PURPOSE To determine if symptomatic patients referred for radiographic stool quantification have equivalent stool burden to asymptomatic patients. METHOD This was an IRB-approved HIPAA-compliant retrospective equivalence cohort study. An a priori equivalence power calculation was performed. Consecutive abdominal radiographs performed in adult outpatients with bloating, constipation, diarrhea, or abdominal pain to assess "fecal loading" [n = 242 (fecal cohort)] were compared to those performed in asymptomatic adult outpatients to assess "renal stones" [n = 242 (renal cohort)]. Radiographs were randomized and reviewed by two blinded independent abdominal radiologists. Exclusion criteria, designed to avoid unblinding, included urinary tract calculi ≥ 0.5 cm, multiple urinary tract calculi, and ureteral stent(s). Readers scored all radiographs (n = 484) for stool burden using validated Leech criteria [scale: 0 (none) to 15 (extreme diffuse)]. Mean Leech scores and 95% confidence intervals were calculated. Multivariable generalized linear modeling was performed to adjust for baseline medication use, age, and gender. The adjusted parameter estimate was used to test for equivalence in the mean difference between cohorts using Schuirmann's method of two one-sided t-tests. Inter-reader agreement was assessed with intraclass correlation coefficients. RESULTS Overall mean Leech scores for fecal [6.9 (95% CI 6.7, 7.2)] and renal [7.3 (95% CI 7.1, 7.5)] cohorts were equivalent within a margin of 0.75 (adjusted mean difference: - 0.4 [90% CI - 0.7, - 0.04]; p value = 0.02). Inter-reader agreement was good [ICC: 0.62 (95% CI 0.56, 0.68)]. CONCLUSION Radiographic stool quantification produces equivalent results in symptomatic and asymptomatic adults and is of uncertain value.

中文翻译：

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放射照相的粪便定量：对484名有症状和无症状受试者的等效研究。

目的确定有影像学检查的有症状患者是否具有与无症状患者同等的大便负担。方法这是一项IRB批准的符合HIPAA要求的回顾性等效队列研究。进行先验等效功率计算。将在有腹胀，便秘，腹泻或腹痛的成人门诊患者连续进行腹部X线照片以评估“粪便负荷” [n = 242（粪便队列）]，与在无症状成人门诊患者中进行连续腹部X线照片以评估“肾结石” [n = 242（肾脏队列）]。放射线照片由两名独立的腹部腹部放射线医师随机化和审查。旨在避免失明的排除标准包括≥0.5 cm的尿路结石，多条尿路结石和输尿管支架。读者使用经过验证的水criteria标准[等级：0（无）至15（极度弥散）]对所有X光片（n = 484）的粪便负担进行评分。计算平均水ch得分和95％置信区间。进行多变量广义线性建模以调整基线药物的使用，年龄和性别。调整后的参数估计值用于使用两个单侧t检验的Schuirmann方法测试队列之间的平均差异是否相等。阅读者之间的一致性是通过类内相关系数来评估的。结果粪便[6.9（95％CI 6.7，7.2）]和肾脏[7.3（95％CI 7.1，7.5）]队列的总体平均水Lee评分在0.75的范围内相等（调整后的均数差：-0.4 [90％CI -0.7，-0.04]； p值= 0.02）。读者间的共识很好[ICC：0.62（95％CI 0.56，0.68）。