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Cited by 7Gut microbiota and healthGastrointestinal motility and disordersProbiotics and Fermented Foods

Dys-R Questionnaire: A Novel Screening Tool for Dysbiosis Linked to Impaired Gut Microbiota Richness

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Balmant, Bianca Depieri, Fonseca, Danielle Cristina, Rocha, Ilanna Marques, Callado, Letícia, Torrinhas, Raquel Susana Matos de Miranda, Waitzberg, Dan Linetzky·2023·Nutrients
DOI 10.3390/nu15194261PMC PMC10574031
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Abstract

Practical and affordable tools to screen intestinal dysbiosis are needed to support clinical decision making. Our study aimed to design a new subjective screening tool for the risk of intestinal dysbiosis from a previously described nonvalidated questionnaire (DYS/FQM) and based on subjective and objective data. A total of 219 individuals comprised the chronic diseases (CD; n = 167) and healthy control (HC; 52 subjects) groups. Sociodemographic, anthropometric, body composition, lifestyle, past history, intestinal health, and dietary data were collected. The gut microbiota (GM) profile was assessed from fecal samples using the 16S rRNA sequencing. Scores for the new tool (Dys-R Questionnaire) were assigned using discrete optimization techniques. The association between Dys-R scores and dysbiosis risk was assessed through correlation, simple linear models, sensitivity, specificity, as well as positive and negative predictive values. We found significant differences in the Chao1 Index between CD and HC groups (adjusted p-value = 0.029), highlighting lower GM richness as the primary marker for intestinal dysbiosis. DYS/FQM showed poor performance in identifying poor GM richness. Dys-R exhibited a 42% sensitivity, 82% specificity, 79% positive predictive value (PPV), and 55% negative predictive value (NPV) to identify poor GM richness. The new Dys-R questionnaire showed good performance in ruling out dysbiosis.

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  • The Dys-R questionnaire was developed in Brazil in 2023 using a sample of 219 individuals with chronic diseases and a control group of 52 healthy participants from a tertiary hospital.

    “The Dys-R questionnaire was developed in Brazil in 2023 using a sample of 219 individuals with chronic diseases and a control group of 52 healthy participants from a tertiary hospital.”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [79]

    Methods §2.1 reports recruitment at a São Paulo hospital, with 167 patients with chronic diseases and 52 healthy volunteers. Methods §2.5 gives 219 as the total number of individuals used in the analysis, not the number with chronic diseases. The claim gets the group sizes wrong by treating the total as the chronic-disease group. (LLM, conf=0.93)

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  • The Dys-R questionnaire showed a positive predictive value of 79% and good performance to rule out dysbiosis.

    “The results showed that there were notable differences between the groups, evidencing a lower richness of intestinal microbiota as the main marker of intestinal dysbiosis and a positive predictive value of 79%, concluding that the new Dys-R questionnaire showed a good performance to rule out dysbiosis [79].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [79]

  • Lower richness of intestinal microbiota was the main marker of intestinal dysbiosis in the Dys-R development study.

    “The results showed that there were notable differences between the groups, evidencing a lower richness of intestinal microbiota as the main marker of intestinal dysbiosis and a positive predictive value of 79%, concluding that the new Dys-R questionnaire showed a good performance to rule out dysbiosis [79].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [79]

  • When sequencing is not available, complementary tools such as the Dys-R questionnaire, the Bristol scale with medication history, diet evaluation based on intestinal microbiota, and the gastrointestinal function evaluation scale can be integrated into ecological assessment.

    “These include the Dys-R questionnaire (Table 8) [79], the Bristol scale together with medication history (antibiotics and non-antibiotics) [65,80,81], evaluation of diet based on the intestinal microbiota [82] (Table 9), and, in the case of oncological patients, the gastrointestinal function evaluation scale (Table 10) [83].”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [79]

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Cited by

Sorted by citations

Authors
Balmant, B. D., Fonseca, D. C., Rocha, I. M., Callado, L., Torrinhas, R. S. M. D. M., & Waitzberg, D. L.
Affiliations
Universidade de São Paulo (BR)
Corresponding author
Waitzberg, Dan Linetzky
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2023-10-05
Volume
15
Issue
19
Pages
4261
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu15194261
PMC
PMC10574031
OpenAlex
W4387377359
Cited by
7
References
2
Citations by year
2026: 4 · 2025: 3
FWCI
0.62
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
Farmoquímica S.A
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
Keywords
gut dysbiosis, chronic disease, 16S rRNA gene sequencing, Chao1 index, questionnaire validation, sensitivity and specificity, fecal microbiota
MeSH terms
Gastrointestinal Microbiome, Feces, Humans, Intestines, Surveys and Questionnaires, RNA, Ribosomal, 16S, Dysbiosis

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