Saps Miguel, Nichols-Vinueza Diana X, Mintjens Stijn, Pusatcioglu Cenk K, Velasco-Benítez Carlos A
*Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL †Department of Hematology, Boston Children's Hospital, Boston, MA ‡Department of Pediatrics, Emma Kinderziekenhuis, Academic Medical Centre, Amsterdam, The Netherlands §Department of Pediatrics, Universidad del Valle, Cali, Colombia.
J Pediatr Gastroenterol Nutr. 2014 Nov;59(5):577-81. doi: 10.1097/MPG.0000000000000482.
Functional gastrointestinal disorders (FGIDs) are common. The diagnosis of FGIDs is based on the Rome criteria, a symptom-based diagnostic classification established by expert consensus. There is little evidence of validity for the pediatric Rome III criteria. The construct validity of the criteria, an overarching term that incorporates other forms of validity, has never been assessed. We assessed the construct validity of the Rome III criteria.
Children from 2 schools in Colombia completed the Questionnaire on Pediatric Gastrointestinal Symptoms at baseline and weekly questionnaires of somatic symptoms and disability for 8 weeks (presence and intensity of gastrointestinal symptoms, nongastrointestinal symptoms, impact on daily activities). A total of 255 children completed at least 6 weekly surveys (2041 surveys).
At baseline, 27.8% children were diagnosed as having an FGID. Prevalence of nausea (Δ 7.8%, 95% confidence interval [CI] 4.46-11.14), constipation (Δ 4.39%, 95% CI 1.79-6.99), diarrhea (Δ 6.69%, 95% CI 3.25-10.13), headache (Δ 7.4%, 95% CI 3.51-11.09), chest pain (Δ 9.04%, 95% CI 5.20-12.88), and limb pain (Δ 4.07%, 95% CI 1.76-6.37) and intensity of nausea (Δ 0.23, 95% CI 0.127-0.333), diarrhea (Δ 0.30, 95% CI 0.211-0.389), abdominal pain (Δ 0.18, 95% CI 0.069-0.291), headache (Δ 0.17, 95% CI 0.091-0.249), and limb pain (Δ 0.30, 95% CI 0.084-0.516) were higher in children with FGIDs (P < 0.001). Children with FGIDs had greater interference with daily activities (P < 0.001).
Children with a Rome III diagnosis had significantly more gastrointestinal and nongastrointestinal complaints, and greater intensity of symptoms and disability than children without an FGID diagnosis. The study suggests that the Rome III pediatric criteria have adequate construct validity.
功能性胃肠病（FGIDs）很常见。FGIDs的诊断基于罗马标准，这是一个基于症状的诊断分类，由专家共识制定。几乎没有证据表明儿科罗马Ⅲ标准具有有效性。该标准的结构效度（一个包含其他形式效度的总体术语）从未被评估过。我们评估了罗马Ⅲ标准的结构效度。
来自哥伦比亚2所学校的儿童在基线时完成了《儿科胃肠道症状问卷》，并在8周内每周完成躯体症状和残疾问卷（胃肠道症状的存在和强度、非胃肠道症状、对日常活动的影响）。共有255名儿童完成了至少6次每周调查（共2041次调查）。
在基线时，27.8%的儿童被诊断为患有FGID。FGID儿童的恶心患病率（变化值7.8%，95%置信区间[CI]4.46 - 11.14）、便秘患病率（变化值4.39%，95% CI 1.79 - 6.99）、腹泻患病率（变化值6.69%，95% CI 3.25 - 10.13）、头痛患病率（变化值7.4%，95% CI 3.51 - 11.09）、胸痛患病率（变化值9.04%，95% CI 5.20 - 12.88）和肢体疼痛患病率（变化值4.07%，95% CI 1.76 - 6.37）以及恶心强度（变化值0.23, 95% CI 0.127 - 0.333）、腹泻强度（变化值0.30, 95% CI 0.211 - 0.389）、腹痛强度（变化值0.18, 95% CI 0.069 - 0.291）、头痛强度（变化值0.17, 95% CI 0.091 - 0.249）和肢体疼痛强度（变化值0.30, 95% CI 0.084 - 0.516）均更高（P < 0.001）。FGID儿童对日常活动的干扰更大（P < 0.001）。
与未被诊断为FGID的儿童相比，被诊断为罗马Ⅲ标准的儿童有明显更多的胃肠道和非胃肠道主诉，症状强度和残疾程度更高。该研究表明罗马Ⅲ儿科标准具有足够的结构效度。
