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Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians
Olafur S Palsson1, William E Whitehead2, Miranda A L van Tilburg3
1Bioinformatics Building Room 4111, Campus Box 7080, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7080.
Gastroenterology
|May 5, 2016
Summary
The Rome IV Diagnostic Questionnaires effectively screen for functional gastrointestinal disorders (FGIDs) in adults, showing high specificity but moderate sensitivity for conditions like irritable bowel syndrome (IBS) and functional dyspepsia (FD).
Area of Science:
- Gastroenterology
- Clinical Diagnostics
- Epidemiology
Background:
- Functional gastrointestinal disorders (FGIDs) require reliable diagnostic tools.
- Existing screening methods may lack sufficient accuracy or standardization.
- The Rome criteria are widely used but require validated diagnostic questionnaires.
Purpose of the Study:
- To develop and validate the Rome IV Diagnostic Questionnaires for screening FGIDs.
- To establish thresholds for abnormal symptom frequency.
- To assess the diagnostic sensitivity and specificity of the adult questionnaire.
Main Methods:
- Surveyed 1,162 adults without FGIDs to set abnormal symptom thresholds (90th percentile).
- Formulated and refined diagnostic questions with clinical experts.
- Tested sensitivity in 843 FGID patients and specificity in 5,931 adults.
- Assessed understandability and reproducibility of the questionnaire.
Main Results:
- Adult questionnaire showed high specificity (93.3-97.1%) for IBS, FD, and FC.
- Sensitivity varied: IBS (62.7%), FD (54.7%), FC (32.2%).
- Reduced sensitivity was linked to symptom overlap; allowing IBS-FC overlap improved FC sensitivity to 73.2%.
- Questions were understandable to >90% and diagnoses reproducible in 75% after one month.
Conclusions:
- The Rome IV adult questionnaire is a valid tool with high specificity for diagnosing FGIDs.
- Symptom overlap impacts sensitivity, suggesting a need to consider co-occurring conditions.
- Ongoing validation is planned for pediatric questionnaires.
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