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Establishment of a nomogram for predicting functional constipation among children in China: Using the Rome IV
Qilian Zhou1, Yuxia Tang1, Liping Yuan1
1Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
Insights
Childhood functional constipation (FC) is a growing concern. This study identified inadequate sleep, picky eating, and family history as key risk factors for FC in Chinese children, developing a predictive nomogram.
Area of Science:
- Pediatrics
- Gastroenterology
- Public Health
Background:
- Childhood functional constipation (FC) is an emerging public health issue.
- Diagnosis of FC adheres to the Rome IV criteria.
- Prevalence of FC in Chinese children was found to be 11.3%.
Purpose of the Study:
- To develop a personalized nomogram for predicting incident FC in Chinese children.
- To identify key risk factors contributing to FC development.
Main Methods:
- A cross-sectional study involving 832 Chinese children from Anhui province.
- Data collected via electronic questionnaires completed by primary caregivers.
- Multivariate logistic regression analysis to identify risk factors and construct a predictive nomogram.
Main Results:
- Inadequate sleep, picky eating, and a positive family history of FC were identified as significant risk factors.
- The developed nomogram demonstrated an area under the receiver operating characteristic curve of 0.694.
- Calibration curves indicated that the nomogram's predicted probabilities closely approximated the actual FC prevalence.
Conclusions:
- Inadequate sleep, picky eating, and family history are significant risk factors for childhood FC.
- A validated, easy-to-use nomogram can aid clinicians in predicting FC risk.
- The nomogram facilitates optimized disease prevention and intervention strategies for childhood FC.
Background And Study Aims:
Childhood functional constipation (FC) is gradually becoming an emerging public health problem. This study aimed to develop a personalized nomogram for the prediction of incident FC among Chinese children, and the diagnosis of FC was based on the Rome IV criteria.
Patients And Methods:
This cross-sectional study was conducted from Nov. 2020 to Jan. 2021 among children residing in Anhui province, China. An electronic questionnaire regarding the general demographic and clinical characteristics of all children was completed by their primary caregivers. The multivariate logistic regression analysis was applied to identify risk factors for FC. Moreover, a nomogram was constructed for FC based on the risk factors identified from the multivariate analysis.
Results:
In this study, a total of 901 electronic questionnaires were collected, of which 832 (92.3%) questionnaires were properly completed and included in the final analysis. The prevalence of FC among Chinese children was 11.3% based on the Rome IV criteria. After controlling for potential confounding factors, the multivariate logistic regression analysis showed that inadequate sleep, picky eating, and positive family history of FC were identified as key risk factors of FC. The area under the receiver operating characteristic curve of the nomogram was 0.694 (95 %CI: 0.6412-0.7459). Further, a calibration curve drawn illustrated that the predicted probabilities reasonably approximately the actual prevalence of FC in this population.
Conclusion:
Inadequate sleep, picky eating, and positive family history of FC were identified as risk factors of FC. An easy-to-use nomogram was constructed based on these three significant factors. Besides, this nomogram was validated to have acceptable discrimination and calibration capabilities. Hence, this nomogram may enable clinical professionals to predict the risk of FC among Chinese children and further provide optimized disease prevention and intervention for this population.
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