Universidad del Valle, Cali, Colombia.
Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain.
J Pediatr Gastroenterol Nutr. 2021 Apr 1;72(4):538-541. doi: 10.1097/MPG.0000000000003030.
The diagnosis of functional gastrointestinal disorders (FGIDs) centers on symptoms-based criteria (Rome criteria). The last edition of the criteria was published in 2016. Still, few data on its validity support its use in children. We conducted a study aimed at determining the diagnostic accuracy of the Rome IV criteria through the application of questionnaires (Questionnaire of Pediatric Gastrointestinal Symptoms-Rome IV QPGS-IV) to diagnose FGIDs in children. We hypothesized that the Rome IV criteria has adequate diagnostic accuracy supporting its use for diagnosing FGIDs in children.
School children ages 10 to 18 years from Cali (Colombia) completed the Spanish version of the QPGS-IV. Children with FGIDs were matched with a group of children without FGIDs. Both groups had a medical consultation with a blinded experienced pediatric gastroenterologist (criterion standard) who provided his diagnosis. The questionnaire-based diagnoses were compared with the consultation's diagnoses.
Of 487 schoolchildren surveyed with the QPGS-IV, 97 (20.8%) had FGIDs. Eighty-nine with FGIDs were matched with 92 children without FGIDs (mean age 13.1 years [±1.3]). We found a higher prevalence of FGIDs during the medical visit than using the self-report QPGS-IV (66.3% vs 49.2%, P = 0.001), mainly in abdominal pain disorders (19.3% vs 10.5%, P = 0.013). The Rome IV diagnostic criteria using the QPGS-IV had a sensitivity of 75% (95% confidence interval, 59-79) and 90% specificity (95% confidence interval, 83-98). Positive predictive value is 85.8%, and negative predictive value is 79.9%.
Our study suggests that the QPGS-IV has adequate diagnostic accuracy.
功能性胃肠疾病（FGIDs）的诊断以基于症状的标准（罗马标准）为中心。该标准的最新版本于 2016 年发布。然而，关于其有效性的数据很少支持其在儿童中的应用。我们进行了一项研究，旨在通过应用问卷（罗马 IV 标准的儿科胃肠症状问卷 [QPGS-IV]）来诊断儿童 FGIDs，以确定罗马 IV 标准的诊断准确性。我们假设罗马 IV 标准具有足够的诊断准确性，支持其用于诊断儿童 FGIDs。
来自哥伦比亚卡利的 10 至 18 岁的学龄儿童完成了 QPGS-IV 的西班牙语版本。患有 FGIDs 的儿童与一组无 FGIDs 的儿童相匹配。两组均由一位经验丰富的儿科胃肠病学家进行医疗咨询（标准诊断），并提供其诊断结果。将基于问卷的诊断与咨询的诊断进行比较。
在接受 QPGS-IV 调查的 487 名学龄儿童中，有 97 人（20.8%）患有 FGIDs。89 名 FGIDs 患儿与 92 名无 FGIDs 患儿相匹配（平均年龄 13.1 岁 [±1.3]）。我们发现，在医疗就诊中 FGIDs 的患病率高于使用自我报告的 QPGS-IV（66.3%比 49.2%，P=0.001），主要是在腹痛障碍中（19.3%比 10.5%，P=0.013）。使用 QPGS-IV 的罗马 IV 诊断标准具有 75%的敏感性（95%置信区间，59-79）和 90%的特异性（95%置信区间，83-98）。阳性预测值为 85.8%，阴性预测值为 79.9%。
我们的研究表明，QPGS-IV 具有足够的诊断准确性。
