Farup Per G, Vandvik Per O, Aabakken Lars
Unit for Applied Clinical Research, Norwegian University of Science and Technology, Trondheim, Norway.
Scand J Gastroenterol. 2005 Nov;40(11):1284-9. doi: 10.1080/00365520510023576.
The Rome II criteria are a classification of functional gastrointestinal disorders. It is not known whether they can be used as a diagnostic tool. This study evaluates the agreement between GPs and the Rome II criteria on the diagnosis of upper gastrointestinal disorders.
Consecutive patients with abdominal complaints were included in this pragmatic cross-sectional study. All patients answered a questionnaire based on the Rome II criteria. The diagnoses based on these criteria were compared with the GPs' diagnoses.
A total of 549 consecutively selected patients were included in the study. The agreement between GPs and the Rome II criteria was 65%, kappa 0.34 (CI 0.27-0.41). The agreement was lower when dyspepsia and gastroesophageal reflux/functional heartburn were evaluated separately. The positive and negative predictive values of the Rome II criteria varied between 29-58% and 82-90%, respectively, in various groups of patients with confirmed diagnoses.
The GPs' diagnoses differed from those based entirely on the Rome II criteria. Strict adherence to the criteria will result in other diseases being disregarded. The diagnoses of upper gastrointestinal disorders should be based on all available information and the Rome II criteria used only as an additional aid to improve the precise classification of functional disorders.
罗马II标准是对功能性胃肠疾病的一种分类。目前尚不清楚它们是否可作为一种诊断工具。本研究评估了全科医生（GP）的诊断与罗马II标准在上消化道疾病诊断方面的一致性。
本实用横断面研究纳入了连续的有腹部不适症状的患者。所有患者都回答了一份基于罗马II标准的问卷。将基于这些标准的诊断与全科医生的诊断进行比较。
本研究共纳入了549例连续选取的患者。全科医生与罗马II标准之间的一致性为65%，kappa值为0.34（95%可信区间0.27 - 0.41）。当分别评估消化不良和胃食管反流/功能性烧心时，一致性较低。在确诊的不同患者组中，罗马II标准的阳性预测值和阴性预测值分别在29% - 58%和82% - 90%之间。
全科医生的诊断与完全基于罗马II标准的诊断不同。严格遵循这些标准会导致其他疾病被忽视。上消化道疾病的诊断应基于所有可用信息，罗马II标准仅作为辅助手段以改善功能性疾病的精确分类。
