Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Pediatric Gastroenterology, Amsterdam, The Netherlands.
Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, Netherlands.
Eur J Pediatr. 2021 Jul;180(7):2297-2303. doi: 10.1007/s00431-021-04013-2. Epub 2021 Mar 18.
To evaluate the agreement between the Rome III and Rome IV criteria in diagnosing pediatric functional gastrointestinal disorders (FGIDs), we conducted a prospective cohort study in a public school in Cali, Colombia. Children and adolescents between 11 and 18 years of age were given the Spanish version of the Questionnaire on Pediatric Functional Gastrointestinal Disorders Rome III version on day 0 and Rome IV version on day 2 (48 h later). The study protocol was completed by 135 children. Thirty-nine (28.9%) children were excluded because of not following the instructions of the questionnaire. The final analysis included data of 96 children (mean 15.2 years old, SD ± 1.7, 54% girls). Less children fulfilled the criteria for an FGID according to Rome IV compared to Rome III (40.6% vs 29.2%, p=0.063) resulting in a minimal agreement between the two criteria in diagnosing an FGID (kappa 0.34, agreement of 70%). The prevalence of functional constipation according to Rome IV was significantly lower compared to Rome III (13.5% vs 31.3%, p<0.001), whereas functional dyspepsia had a higher prevalence according to Rome IV than Rome III (11.5% vs 0%).Conclusion: We found an overall minimal agreement in diagnosing FGIDs according to Rome III and Rome IV criteria. This may be partly explained by the differences in diagnostic criteria. However, limitations with the use of questionnaires to measure prevalence have to be taken into account. What is Known: • The Rome IV criteria replaced the previous Rome III criteria providing updated criteria to diagnose functional gastrointestinal disorders (FGIDs). • Differences found between Rome IV and historic Rome III FGID prevalence may have been affected by changes in prevalence over time or differences in sample characteristics. What is New: • We found a minimal agreement between Rome III and Rome IV FGID diagnosis, especially in the diagnoses of functional constipation, irritable bowel syndrome, and functional dyspepsia. • The minimal agreement may be partly explained by changes in diagnostic criteria, but limitations with the use of questionnaires to measure prevalence have to be taken into account.
为了评估罗马 III 标准和罗马 IV 标准在诊断小儿功能性胃肠疾病（FGIDs）方面的一致性，我们在哥伦比亚卡利的一所公立学校进行了一项前瞻性队列研究。在第 0 天和第 2 天（48 小时后），11 至 18 岁的儿童和青少年接受了西班牙语版的罗马 III 版和罗马 IV 版儿童功能性胃肠疾病问卷。135 名儿童完成了研究方案。由于未按问卷说明进行操作，有 39 名（28.9%）儿童被排除在外。最终分析包括 96 名儿童的数据（平均年龄 15.2 岁，标准差 ± 1.7，54%为女孩）。与罗马 III 相比，根据罗马 IV 标准，符合 FGID 标准的儿童比例较低（40.6%比 29.2%，p=0.063），这导致两种标准在诊断 FGID 方面的一致性较差（kappa 值 0.34，一致性为 70%）。根据罗马 IV 标准，功能性便秘的患病率明显低于罗马 III 标准（13.5%比 31.3%，p<0.001），而根据罗马 IV 标准，功能性消化不良的患病率高于罗马 III 标准（11.5%比 0%）。结论：我们发现根据罗马 III 和罗马 IV 标准诊断 FGIDs 的总体一致性较差。这可能部分归因于诊断标准的差异。然而，在使用问卷来衡量患病率时，必须考虑到其局限性。已知：•罗马 IV 标准取代了之前的罗马 III 标准，为功能性胃肠道疾病（FGIDs）的诊断提供了更新的标准。•与罗马 IV 相比，历史上罗马 III FGID 患病率的差异可能受到随时间推移而发生的患病率变化或样本特征差异的影响。新发现：•我们发现罗马 III 和罗马 IV FGID 诊断之间的一致性较差，特别是在功能性便秘、肠易激综合征和功能性消化不良的诊断中。•这种一致性较差可能部分归因于诊断标准的变化，但在使用问卷来衡量患病率时，必须考虑到其局限性。
