Enteric NeuroScience Program, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Neurogastroenterol Motil. 2018 Sep;30(9):e13356. doi: 10.1111/nmo.13356. Epub 2018 Apr 27.
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, diagnosed on symptom-based criteria. Many have reported discrepancies between formal Rome criteria and diagnoses made in clinical practice. The aim of the study was to explore whether a quantitative version of the Rome criteria would better represent a clinical diagnosis of IBS than the current dichotomous criteria for symptom measure.
As part of a large, case-control study, participants completed a validated bowel disease questionnaire. Rome criteria were analyzed based on 15 individual symptoms. Penalized logistic regression model with stepwise selection was used to identify significant symptoms of IBS which were independently associated with case-control status.
In cases with a clinical diagnosis of IBS, 347 (70%) met Rome criteria for IBS. Increasing number of Rome symptoms were found related to the odds of being diagnosed with IBS. Nearly half of the Rome-negative case group experienced infrequent symptoms suggesting milder disease. Five of 15 Rome symptoms were associated with predicting case-control status in the final model, with 96% correctly classified among Rome-positive cases, 76% for Rome-negative cases, and 91% for controls.
Irritable bowel syndrome appears to be a spectrum disorder. Quantifying individual symptoms of Rome criteria has greater utility than the current application in representing the degree of IBS affectedness and appears to better reflect a clinical diagnosis of IBS applied by physicians. The use of a quantitative diagnostic Rome "score" may be helpful in clinical practice and research studies to better reflect the degree an individual is affected with IBS.
肠易激综合征（IBS）是一种常见的功能性胃肠道疾病，根据症状标准进行诊断。许多人报告说，罗马标准与临床实践中的诊断之间存在差异。本研究旨在探讨定量罗马标准是否比目前用于症状测量的二分法标准更能代表 IBS 的临床诊断。
作为一项大型病例对照研究的一部分，参与者完成了一份经过验证的肠道疾病问卷。根据 15 项个体症状分析罗马标准。使用逐步选择的惩罚逻辑回归模型来确定与病例对照状态独立相关的 IBS 显著症状。
在有临床诊断为 IBS 的病例中，347 例（70%）符合 IBS 的罗马标准。发现罗马症状的数量增加与被诊断为 IBS 的几率相关。近一半的罗马阴性病例组经历了不频繁的症状，表明疾病较轻。在最终模型中，有 5 项罗马症状与预测病例对照状态相关，罗马阳性病例中有 96%被正确分类，罗马阴性病例中有 76%，对照组中有 91%。
肠易激综合征似乎是一种谱障碍。定量罗马标准的个体症状比当前应用更能代表 IBS 的受影响程度，并且似乎更能反映医生应用的 IBS 临床诊断。使用定量诊断罗马“评分”可能有助于临床实践和研究研究，以更好地反映个体受 IBS 影响的程度。
