Siawash Murid, van Assen Tijmen, Tjon A Ten Walther, Janssen Loes, van Heurn Ernst, Roumen Rudi, Scheltinga Marc
SolviMáx, Center of Excellence for Abdominal Wall and Groin Pain, Department of Surgery, Máxima Medical Center, Veldhoven.
Department of Rehabilitation, Physiotherapy Sciences & Sport, University Medical Center Utrecht.
J Pediatr Gastroenterol Nutr. 2019 Sep;69(3):e65-e69. doi: 10.1097/MPG.0000000000002366.
A questionnaire study demonstrated that some adult patients who were diagnosed with irritable bowel syndrome (IBS) were in fact having an abdominal wall pain syndrome, such as anterior cutaneous nerve entrapment syndrome (ACNES). The aim of the present study was to investigate whether a pediatric version of this questionnaire was useful in diagnosing abdominal wall pain syndromes in children with chronic abdominal pain (CAP).
An 18-item questionnaire was tested in 3 groups of children with CAP: group 1, children who underwent surgery for ACNES (n = 42); group 2, children who were found to have ACNES after an outpatient analysis (n = 57); and group 3, children diagnosed with IBS (n = 53). Qualities including internal consistency (Cronbach α), cut-off points and a ROC-curve were calculated using standard statistical analysis.
Questionnaire response rates in the three populations of CAP children ranged from 69% to 92%. When comparing ACNES and IBS groups, 17 of 18 questions were discriminative (P < 0.01, Cronbach α 0.74). Total questionnaire scores ranged from 0 (IBS likely) to 17 points (ACNES likely). A median 13-point score (range 8-17) was found in both ACNES groups. In contrast, a median 8-point score was calculated in children with IBS (range 3-13, P < 0.01). Using an 11-point cut-off score, a child with CAP was diagnosed with ACNES with 86% sensitivity and 89% specificity. A ROC curve with an AUC of 0.94 was obtained.
A 17-item questionnaire showed good diagnostic test properties and may aid in distinguishing ACNES from IBS in pediatric populations with chronic abdominal pain.
一项问卷调查研究表明，一些被诊断为肠易激综合征（IBS）的成年患者实际上患有腹壁疼痛综合征，如前皮神经卡压综合征（ACNES）。本研究的目的是调查该问卷的儿童版是否有助于诊断慢性腹痛（CAP）儿童的腹壁疼痛综合征。
在3组CAP儿童中测试了一份包含18个条目的问卷：第1组，接受ACNES手术的儿童（n = 42）；第2组，门诊分析后发现患有ACNES的儿童（n = 57）；第3组，诊断为IBS的儿童（n = 53）。使用标准统计分析计算包括内部一致性（Cronbach α）、截断点和ROC曲线等指标。
三组CAP儿童的问卷回复率在69%至92%之间。比较ACNES组和IBS组时，18个问题中的17个具有鉴别性（P < 0.01，Cronbach α 0.74）。问卷总分范围从0分（可能为IBS）到17分（可能为ACNES）。两个ACNES组的中位得分为13分（范围8 - 17）。相比之下，IBS儿童的中位得分为8分（范围3 - 13，P < 0.01）。使用11分的截断分数，CAP儿童被诊断为ACNES的敏感性为86%，特异性为89%。获得了一条AUC为0.94的ROC曲线。
一份包含17个条目的问卷显示出良好的诊断测试性能，可能有助于在患有慢性腹痛的儿科人群中区分ACNES和IBS。
