Development and Validation of the Rome IV Diagnostic Questionnaire for Adults

被引：492

作者：

Palsson, Olafur S. ^{[1
]}

Whitehead, William E. ^{[1
]}

van Tilburg, Miranda A. L. ^{[1
]}

Chang, Lin ^{[2
]}

Chey, William ^{[3
]}

Crowell, Michael D. ^{[4
]}

Keefer, Laurie ^{[5
]}

Lembo, Anthony J. ^{[6
]}

Parkman, Henry P. ^{[7
]}

Rao, Satish S. C. ^{[8
]}

Sperber, Ami ^{[9
]}

Spiegel, Brennan ^{[10
]}

Tack, Jan ^{[11
]}

Vanner, Stephen ^{[12
]}

Walker, Lynn S. ^{[13
]}

Whorwell, Peter ^{[14
]}

Yang, Yunsheng ^{[15
]}

机构：

[1] Univ N Carolina, Chapel Hill, NC USA

[2] Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurobiol Stress, Los Angeles, CA 90095 USA

[3] Univ Michigan Hlth Syst, Div Gastroenterol, Ann Arbor, MI USA

[4] Mayo Clin, Scottsdale, AZ USA

[5] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA

[6] Harvard Univ, Sch Med, Boston, MA USA

[7] Temple Univ, Lewis Katz Sch Med, Philadelphia, PA 19122 USA

[8] Georgia Regents Univ, Digest Hlth Ctr, Med Coll Georgia, Augusta, GA USA

[9] Kibbutz Farod, DN Bikat Bet Hakerem, Israel

[10] Mt Sinai Med Ctr, Los Angeles, CA USA

[11] KU Leuven Ctr GI Res, Leuven, Belgium

[12] Kingston Gen Hosp, Div Gastroenterol, Kingston, ON K7L 2V7, Canada

[13] Vanderbilt Univ, Med Ctr, Dept Pediat, Adolescent Div, Nashville, TN 37232 USA

[14] Univ S Manchester Hosp, Manchester, Lancs, England

[15] Chinese Peoples Liberat Army Gen Hosp, Beijing 100853, Peoples R China

来源：

GASTROENTEROLOGY | 2016年 / 150卷 / 06期

关键词：

Sensitivity; Specificity; Functional Gastrointestinal Disorder; Irritable Bowel Syndrome; Functional Constipation; Functional Dyspepsia; IRRITABLE-BOWEL-SYNDROME; FUNCTIONAL GASTROINTESTINAL DISORDERS; III CRITERIA; SYMPTOMS; CONSTIPATION; AGREEMENT;

D O I：

10.1053/j.gastro.2016.02.014

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The Rome IV Diagnostic Questionnaires were developed to screen for functional gastrointestinal disorders, serve as inclusion criteria in clinical trials, and support epidemiologic surveys. Separate questionnaires were developed for adults, children and adolescents, and infants and toddlers. For the adult questionnaire, we first surveyed 1162 adults without gastrointestinal disorders, and recommended the 90th percentile symptom frequency as the threshold for defining what is abnormal. Diagnostic questions were formulated and verified with clinical experts using a recursive process. The diagnostic sensitivity of the questionnaire was tested in 843 patients from 9 gastroenterology clinics, with a focus on clinical diagnoses of irritable bowel syndrome (IBS), functional constipation (FC), and functional dyspepsia (FD). Sensitivity was 62.7% for IBS, 54.7% for FD, and 32.2% for FC. Specificity, assessed in a population sample of 5931 adults, was 97.1% for IBS, 93.3% for FD, and 93.6% for FC. Excess overlap among IBS, FC, and FD was a major contributor to reduced diagnostic sensitivity, and when overlap of IBS with FC was permitted, sensitivity for FC diagnosis increased to 73.2%. All questions were understandable to at least 90% of individuals, and Rome IV diagnoses were reproducible in three-fourths of patients after 1 month. Validation of the pediatric questionnaires is ongoing.

引用

页码：1481 / 1491

页数：11

共 19 条

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