Validation of Modified Rome IV Criteria for IBS
Author Information
Author(s): Vivek C. Goodoory, Christy Riggott, Mais Khasawneh, Christopher J. Black, Alexander C. Ford
Primary Institution: Leeds Gastroenterology Institute St. James's University Hospital Leeds UK
Hypothesis
The Rome IV criteria would be superior to Rome III for the diagnosis of IBS, but that relaxing symptom frequency required for abdominal pain to only 3 days per month would further improve their performance.
Conclusion
A simple modification relaxing the required frequency of abdominal pain improved the performance of the Rome IV criteria for diagnosing IBS.
Supporting Evidence
- The sensitivity of the Rome IV criteria was 82.1% and specificity was 85.1%.
- Modifying the criteria to relax abdominal pain frequency to 3 days per month improved sensitivity to 90.2%.
- The study included 170 patients, with a mean age of 37.9 years and 76.5% being female.
- Only 6.5% of patients meeting Rome IV criteria had organic disease.
- The positive likelihood ratio for the modified criteria was 6.06.
Takeaway
Doctors wanted to see if a new way of diagnosing a tummy problem called IBS could be better by changing some rules. They found that changing one rule made it easier to tell if someone really has the problem.
Methodology
Symptom data were collected from consecutive adults with suspected IBS, and diagnostic performance was assessed using modified Rome IV criteria.
Potential Biases
The patient population may be enriched for a diagnosis of IBS, affecting the generalizability of the results.
Limitations
The study was conducted in a single specialist IBS clinic, which may not represent the general population, and many consultations were conducted over the phone due to COVID-19.
Participant Demographics
170 patients, 76.5% female, mean age 37.9 years.
Statistical Information
P-Value
0.21
Confidence Interval
95% CI 2.95–11.3
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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