Address correspondence and reprint requests to Miguel Saps, MD, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Miller School of Medicine, University of Miami, 1601 NW 12 Ave, Suite 3005A, Miami, FL 33136 (e-mail: [email protected])Search for more papers by this author

Carlos A. Velasco-Benítez,

Carlos A. Velasco-Benítez

Universidad del Valle, Cali, Colombia

Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain

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Lina F. Gómez-Oliveros,

Lina F. Gómez-Oliveros

Universidad del Valle, Cali, Colombia

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Lina M. Rubio-Molina,

Lina M. Rubio-Molina

Universidad del Valle, Cali, Colombia

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José R. Tovar-Cuevas,

José R. Tovar-Cuevas

Universidad del Valle, Cali, Colombia

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Miguel Saps,

Corresponding Author

Miguel Saps

[email protected]

Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, FL

First published: 23 December 2020

https://doi.org/10.1097/MPG.0000000000003030

Citations: 18

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org).

The authors report no conflicts of interest.

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ABSTRACT

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.

Methods:

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.

Results:

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%.

Conclusion:

Our study suggests that the QPGS-IV has adequate diagnostic accuracy.

REFERENCES

1.Hyams JS, Di Lorenzo C, Saps M, et al. Childhood functional gastrointestinal disorders: child/adolescent. Gastroenterology 2016; 150: 1456–1468.
10.1053/j.gastro.2016.02.015
Web of Science® Google Scholar
2.Robin SG, Keller C, Zwiener R, et al. Prevalence of pediatric functional gastrointestinal disorders utilizing the Rome IV criteria. J Pediatr 2018; 195: 134–139.
10.1016/j.jpeds.2017.12.012
PubMed Web of Science® Google Scholar
3.Velasco-Benitez CA, Axelrod CH, Gutierrez S, et al. The relationship between prematurity, method of delivery, and functional gastrointestinal disorders in children. J Pediatr Gastroenterol Nutr 2020; 70: e37–e40.
10.1097/MPG.0000000000002543
PubMed Web of Science® Google Scholar
4.Velasco-Benitez CA, Axelrod C, Fernandez-Valdes L, et al. Functional gastrointestinal disorders, autonomic nervous system dysfunction, and joint hypermobility in children: are they related? J Pediatr 2020; 218: 114–120.
10.1016/j.jpeds.2019.11.009
PubMed Web of Science® Google Scholar
5.Velasco-Benítez CA, Ruiz-Extremera A, Saps M. Case-control study on generalized joint hypermobility in schoolchildren with functional gastrointestinal disorders according to Rome IV criteria in Spanish. An Pediatr (Barc) 2019; 91: 401–407.
10.1016/j.anpedi.2019.04.006
Web of Science® Google Scholar
6.Saps M, Velasco-Benitez CA, Langshaw AH, et al. Prevalence of functional gastrointestinal disorders in children and adolescents: comparison between Rome III and Rome IV criteria. J Pediatr 2018; 199: 212–216.
10.1016/j.jpeds.2018.03.037
PubMed Web of Science® Google Scholar
7.Edwards T, Friesen C, Schurman JV. Classification of pediatric functional gastrointestinal disorders related to abdominal pain using Rome III vs. Rome IV criterions. BMC Gastroenterol 2018; 18: 41.
10.1186/s12876-018-0769-z
PubMed Web of Science® Google Scholar
8.Jativa-Mariño E, Rivera-Valenzuela MG, Velasco-Benitez CA, et al. The prevalence of functional constipation in children was unchanged after the Rome IV criteria halved the diagnosis period in Rome III. Acta Pediatr 2019; 108: 2274–2227.
10.1111/apa.14880
CAS PubMed Web of Science® Google Scholar
9.Galai T, Moran-Lev H, Cohen S, et al. Higher prevalence of obesity among children with functional abdominal pain disorders. BMC Pediatr 2020; 20: 193.
10.1186/s12887-020-02106-9
PubMed Web of Science® Google Scholar
10.Zeevenhooven J, Van der Heijden S, Devanarayana NM, et al. Epidemiology of functional abdominal pain disorders and functional defecation disorders in adolescents in Curacao. J Pediatr Gastroenterol Nutr 2020; 70: e71–e76.
10.1097/MPG.0000000000002623
CAS PubMed Web of Science® Google Scholar
11.Tosto M, D’Andrea P, Salamone I, et al. Functional constipation masked as irritable bowel syndrome. BMC Gastroenterol 2020; 20: 86.
10.1186/s12876-020-01244-9
CAS PubMed Web of Science® Google Scholar
12.Streiner D, Norman G, Cairney J. Health Measurement Scales A Practical Guide to Their Development and Use. 5th ed Great Britain: Oxford University Press; 2015.
Google Scholar
13.Luján-Tangarife JA, Cardona-Arias JA. Construcción y validación de escalas de medición en salud: revisión de propiedades psicométricas. Arch Med 2015; 11: 1–10.
Google Scholar
14.Carvajal A, Centeno C, Warson R, et al. Cómo validar un instrumento de medidad de la salud? An Sist Sanit Navar 2011; 34: 63–72.
10.4321/S1137-66272011000100007
CAS PubMed Web of Science® Google Scholar
15.Bravo-Grau S, Cruz JP. Estudios de exactitud diagnóstica: herramientas para su interpretación. Rev Chil Radiol 2015; 21: 158–164.
Google Scholar
16.Velasco-Benítez CA, Ramírez-Hernández DR. Consistencia interna, estabilidad y equivalencia de los Criterios de Roma IV en español para Trastornos Gastrointestinales Funcionales en niños entre 10 y 18 años. In: Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica, eds. Memorias XXV Congreso de la SEGHNP. Madrid: Ergon; 2018: 55–56.
Google Scholar
17.Saps M, Nichols-Vinueza DX, Rosen JM, et al. Prevalence of functional gastrointestinal disorders in colombian school children. J Pediatr 2014; 164: 542.e1–545.e1.
10.1016/j.jpeds.2013.10.088
Web of Science® Google Scholar
18.Zablah R, Velasco-Benítez CA, Merlos I, et al. Prevalencia de trastornos funcionales gastrointestinales en niños en edad escolar en El Salvador. Rev Gastroenterol Mex 2015; 80: 186–191.
10.1016/j.rgmx.2015.03.008
CAS PubMed Web of Science® Google Scholar
19.Játiva E, Velasco-Benítez CA, Kippen IJN, et al. Prevalence of functional gastrointestinal disorders in schoolchildren in ecuador. J Pediatr Gastroenterol Nutr 2016; 63: 25–28.
10.1097/MPG.0000000000001108
PubMed Web of Science® Google Scholar
20.Lu PL, Saps M, Chanis RA, et al. The prevalence of functional gastrointestinal disorders in children in Panama: a school-based study. Acta Paediatr 2016; 105: e232–e236.
10.1111/apa.13379
PubMed Web of Science® Google Scholar
21.Dhroove G, Saps M, García-Bueno C, et al. Prevalencia de trastornos gastrointestinales funcionales en escolares mexicanos. Rev Gastroenterol Mex 2017; 82: 13–18.
10.1016/j.rgmx.2016.05.003
CAS PubMed Web of Science® Google Scholar
22.Mejía M, Velasco-Benítez CA, Díaz J. La prevalencia y las posibles asociaciones de los desórdenes gastrointestinales funcionales en escolares y adolescentes de colegios privados de Managua, Nicaragua. Acta Gastroenterol Latinoam 2017; 47: 163–168.
Google Scholar
23.Saps M, Moreno-Gómez JE, Ramírez-Hernández CR, et al. A nationwide study on the prevalence of functional gastrointestinal disorders in school-children. Bol Med Hosp Infant Mex 2017; 74: 407–412.
10.1016/j.bmhimx.2017.05.005
PubMed Google Scholar
24.Nelissen LG, Koppen IJN, Follett FR, et al. Prevalencia de los trastornos funcionales digestivos entre los adolescentes de Buenos Aires, Argentina. Rev Gastroenterol Mex 2018; 83: 367–374.
10.1016/j.rgmx.2018.02.014
CAS Google Scholar
25.Walker LS, Lipani TA, Greene JW, et al. Recurrent abdominal pain: symptom subtypes based on the Rome II criteria for pediatric functional gastrointestinal disorders. J Pediatr Gastroenterol Nutr 2004; 38: 187–191.
10.1002/j.1536-4801.2004.tb12140.x
PubMed Web of Science® Google Scholar
26.Caplan A, Walker L, Rasquin A. Development and preliminary validation of the questionnaire on pediatric gastrointestinal symptoms to assess functional gastrointestinal disorders in children and adolescents. J Pediatr Gastroenterol Nutr 2005; 41: 296–304.
10.1097/01.mpg.0000172748.64103.33
PubMed Web of Science® Google Scholar
27.Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J Pediatr Gastroenterol Nutr 2005; 41: 305–316.
10.1097/01.mpg.0000172749.71726.13
PubMed Web of Science® Google Scholar
28.Saps M, Nichols-Vinueza DX, Pusatcioglu CK, et al. Construct validity of the pediatric Rome III criteria. J Pediatr Gastroenterol Nutr 2014; 59: 577–581.
10.1097/MPG.0000000000000482
PubMed Web of Science® Google Scholar
29.Kellow JE. The Pro case. The Rome III criteria. Neurogastroenterol Motil 2007; 19: 787–792.
10.1111/j.1365-2982.2007.01002.x
CAS PubMed Web of Science® Google Scholar
30.Quigley EMM. The Con case. The Rome Process and Functional Gastrointestinal Disorders: the barbarians are at the gate!. Neurogastroenterol Motil 2007; 19: 793–797.
10.1111/j.1365-2982.2007.01000.x
CAS PubMed Web of Science® Google Scholar
31.Schurman JV, Hunter HL, Friesen CA. Conceptualization and Treatment of Chronic Abdominal Pain in Pediatric Gastroenterology Practice. J Pediatr Gastroenterol Nutr 2010; 50: 32–37.
10.1097/MPG.0b013e3181ae3610
PubMed Web of Science® Google Scholar
32.Palsson OS, Whitehead WE, Van Tilburg MAL, et al. Development and validation of the Rome IV diagnostic questionnaire for adults. Gastroenterology 2016; 150: 1481–1491.
10.1053/j.gastro.2016.02.014
Web of Science® Google Scholar
33.Dhroove G, Chogle A, Saps M. A million-dollar work-up for abdominal pain: is it worth it? J Pediatr Gastroenterol Nutr 2010; 51: 579–583.
10.1097/MPG.0b013e3181de0639
PubMed Web of Science® Google Scholar

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Volume72, Issue4

April 2021

Pages 538-541

Diagnostic Accuracy of the Rome IV Criteria for the Diagnosis of Functional Gastrointestinal Disorders in Children

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Diagnostic Accuracy of the Rome IV Criteria for the Diagnosis of Functional Gastrointestinal Disorders in Children

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