Chey William D, Olden Kevin, Carter Eric, Boyle John, Drossman Douglas, Chang Lin
University of Michigan, Ann Arbor, USA.
Am J Gastroenterol. 2002 Nov;97(11):2803-11. doi: 10.1111/j.1572-0241.2002.07026.x.
Using interview data from a large, community-based sample of American women, we assessed the lifetime prevalence of irritable bowel syndrome (IBS) using questions consistent with the Rome II criteria, determined the sensitivity of Rome I and II in women diagnosed with IBS by their community physician, and identified whether there are differences in the patients identified by Rome I versus II.
A geographically diverse national probability sample of women diagnosed with IBS was identified and interviewed by telephone screening of a national, random digit dialing sample of households. A parallel national survey of adult females was conducted to determine the lifetime prevalence of IBS in U.S. women. Screening and interviews were conducted by experienced, female interviewers. IBS was defined by variations on the Rome I/II criteria.
In the national community sample, lifetime IBS prevalence was 5.4% using Rome II. Full interviews were completed in 1,014 IBS patients. In the IBS sample, Rome I was significantly more sensitive than Rome II (84% vs 49%, p < 0.001). There was 47% agreement between Rome I and II. Of patients with IBS by Rome I, 58% met Rome II. Only 17.7% did not meet either Rome I or II.
Rome I was more sensitive than Rome II in this community sample of female IBS patients. Rome I/II do not necessarily identify the same IBS patients. These findings have important implications for clinical research in IBS patients and raise questions about whether the Rome II criteria are sensitive enough to be useful in clinical practice.
利用来自美国女性大型社区样本的访谈数据，我们使用与罗马II标准一致的问题评估肠易激综合征（IBS）的终生患病率，确定罗马I和罗马II标准对社区医生诊断为IBS的女性的敏感性，并确定罗马I标准与罗马II标准所识别的患者是否存在差异。
通过对全国随机数字拨号家庭样本进行电话筛查，确定了一个地理分布广泛的被诊断为IBS的女性全国概率样本并对其进行访谈。同时对成年女性进行了一项平行的全国性调查，以确定美国女性IBS的终生患病率。筛查和访谈由经验丰富的女性访谈员进行。IBS根据罗马I/II标准的变体进行定义。
在全国社区样本中，采用罗马II标准得出的IBS终生患病率为5.4%。对1014例IBS患者完成了全面访谈。在IBS样本中，罗马I标准的敏感性显著高于罗马II标准（84%对49%，p<0.001）。罗马I标准与罗马II标准之间的一致性为47%。根据罗马I标准诊断为IBS的患者中，58%符合罗马II标准。只有17.7%的患者既不符合罗马I标准也不符合罗马II标准。
在这个女性IBS患者的社区样本中，罗马I标准比罗马II标准更敏感。罗马I标准和罗马II标准不一定能识别出相同的IBS患者。这些发现对IBS患者的临床研究具有重要意义，并引发了关于罗马II标准在临床实践中是否足够敏感而有用的问题。
