Related Experiment Video
Updated: Aug 8, 2026
Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers
Published on: March 14, 2018
Interobserver and intraobserver reliability of the Rome II criteria in children
Miguel Saps1, Carlo Di Lorenzo
1Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Insights
The pediatric Rome II criteria for diagnosing functional gastrointestinal disorders show low interobserver reliability among specialists and trainees. Further validation is needed to ensure accurate diagnosis in children.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Criteria Reliability
Background:
- Functional gastrointestinal disorders are prevalent in children.
- The pediatric Rome II criteria are proposed for diagnosing these conditions.
- Previous studies show high interobserver reliability for DSM-IV criteria, but Rome II reliability in children is unassessed.
Purpose of the Study:
- To evaluate the interobserver reliability of the pediatric Rome II criteria.
- To assess the diagnostic consistency of Rome II criteria among pediatric gastroenterologists and fellows.
Main Methods:
- Twenty clinical vignettes were provided to 10 pediatric gastroenterologists and 10 fellows.
- Raters used the Rome II criteria to select diagnoses for each vignette.
- Intraobserver reliability was assessed by re-evaluating vignettes after 4 months.
Main Results:
- Low interobserver agreement was found, with kappa coefficients ranging from 0.37 (specialists) to 0.41 (trainees).
- Reliability was particularly low for constipation (k=0.2) and pain (k=0.3) subgroups.
- Intraobserver agreement was higher, with a kappa coefficient of 0.63.
Conclusions:
- The interobserver reliability of the pediatric Rome II criteria is low among pediatric gastroenterologists and fellows.
- These findings suggest that further validation of the Rome II criteria is necessary for reliable pediatric functional gastrointestinal disorder diagnosis.
Background:
Functional gastrointestinal disorders are common in children. It has been suggested that the diagnosis of these conditions should be based on the "pediatric Rome II" criteria. The interobserver reliability for the DSM-IV, another symptom-based criteria is considered almost perfect in multiple studies. There are no studies assessing the reliability of the Rome II criteria in children.
Objectives:
To evaluate the reliability of the pediatric Rome II criteria.
Methods:
Interobserver reliability-Ten pediatric gastroenterologists and 10 fellows in pediatric gastroenterology were provided with 20 clinical vignettes, the Rome II criteria, and a list of 15 possible diagnoses. Each of the raters was instructed to select one or more diagnoses for each vignette. Intraobserver reliability-The specialists were provided with the same set of vignettes 4 months later.
Results:
Average percentage of agreement coefficient: 45% (specialists), 47% (fellows). In order to correct for possible agreement by chance, we calculated the kappa coefficient, a measure of pairwise agreement corrected for chance. Specialists: k = 0.37 (p < 0.0001), trainees: k = 0.41, (p < 0.0001). Physicians with a special interest in functional gastrointestinal disorders (k = 0.37, p < 0.0001), and other specialists (k = 0.38, p < 0.0001). Analysis of data in pain and constipation diagnosis subgroups revealed even lower kappa (constipation: k = 0.2, p < 0.0001; pain: k = 0.3, p < 0.0001). Intraobserver agreement: k = 0.63 (p < 0.0001).
Conclusion:
The interobserver reliability of the Rome II criteria among pediatric gastroenterologists and fellows is low. Further validation of the criteria is necessary.
More Related Videos
Related Concept Videos
02:30Naturalistic Observations
01:29Reliability and Validity