Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .
A validated severity score for haemorrhoids as an essential prerequisite for future haemorrhoid trials
Background There is a lack of st and ardised outcomes for haemorrhoidal disease making comparison between trials difficult . A need for a very well vali date d severity score is essential to facilitate meta- analysis of comparative studies , enabling evidence -based clinical practice . Methods The Hubble trial provides a large cohort of patients with haemorrhoidal disease r and omised to rubber b and ligation ( RBL ) or haemorrhoidal artery ligation .  The  haemorrhoid severity score ( HSS )  was collected on each patient at baseline , 6 weeks and 1 year after intervention . This allows for the responsiveness of the HSS instrument to be examined and compared with a more specific instrument , the Vaizey incontinence score ( also collected ) . Responsiveness was tested using four methods ( effect size , st and ardised response means ( SRM ) , significance of change , and responsiveness statistic ) . Results The four tests of responsiveness demonstrated that the HSS was more responsive to changes in the patient ’s health status following both of the interventions compared to the Vaizey question naire . For example , between baseline and 6 weeks , the RBL intervention effect size scores and SRM calculations indicated a non-significant small amount of change ( 0.20 and 0.16 respectively ) . However , using the HSS , the effect size and SRM demonstrated a large magnitude of change ( 1.12 and 1.01 , respectively ) which was significant . Similar results were observed at 1 year . Significance of change scores and the index of responsiveness were also higher for the HSS question naire than the Vaizey across both treatment modalities . Conclusions The HSS is a highly responsive tool for the detection of changes in haemorrhoid symptoms . It should form an essential patient-reported outcome tool for future studies on haemorrhoidal disease
Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .