As current treatments of cirrhotic ascites are not associated with survival benefit, symptom relief is the major therapeutic end point.
Dr Myrte Neijenhuis and developed a questionnaire, and assessed validity and responsiveness for symptom assessment in cirrhotic ascites.
Ascites-Q was compared with Functional Assessment of Chronic Illness Therapy-Ascites Index, and Japanese Ascites Symptom Inventory-7 (ASI-7) in cirrhotics undergoing large-volume paracentesis.
Convergent validity was defined as correlation >0.4 between ascites questionnaires and quality of life visual analog scale.
|Symptoms decreased after paracentesis|
|American Journal of Gastroenterology|
The research team assessed responsiveness by comparing scores at baseline and 7 days after large-volume paracentesis.
To test discriminative ability, the team compared scores of patients with cirrhotic controls without ascites, and diuretic-sensitive ascites.
The researchers included 90 patients with refractory cirrhotic ascites.
Higher symptoms scores were correlated with lower quality of life, but only Ascites-Q showed convergent validity.
Symptoms decreased after paracentesis.
Ascites-Q and ASI-7 discriminated between controls without ascites, diuretic-sensitive, and refractory ascites, whereas FACIT-AI could not.
The team valiaded ascites-Q at 3 months in an independent cohort with ascites controlled with a pump.
Dr Neijenhuis' team concludes, "The Ascites-Q is the best ascites-specific outcome to evaluate symptom relief in cirrhotic ascites."