Test of the child/adolescent Rome III criteria: agreement with physician diagnosis and daily symptoms


  • Published abstract: Part of this work has previously been presented at Digestive Disease Week 2012 and was published in abstract: van Tilburg, M.A.L., Squires, M., Blois-Martin, N., Leiby, A. & Langseder, A. (2012). Validation of the Child/Adolescent Rome III criteria. Gastroenterology, 142 (5) Suppl. 1, S48.

Address for Correspondence
Miranda van Tilburg, PhD. University of North Carolina, School of Medicine, Department of Gastroenterology and Hepatology, CB 7080, Chapel Hill, NC 27599-7080, USA.
Tel: +1 919 843 0688; fax: +1 919 843 2793;
e-mail: tilburg@med.unc.edu


Background  Establishment of the Rome criteria advanced diagnosis of children with Functional Gastrointestinal Disorders. The criteria were overhauled in 2006, but these revisions were never systematically tested. The aim of the current study was to assess psychometric properties of the childhood Rome III criteria and determine how well they agree with physician diagnoses and daily symptoms.

Methods  A total of N = 135 families from two pediatric gastroenterology clinics completed the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS- RIII). Half of the families completed the QPGS-RIII again in 2 weeks, the other half completed 2-week daily diaries. Children above the age of 10 also provided data (N = 64). Physician diagnoses were obtained from the medical records.

Key Results  Diagnoses: The most common diagnoses per child/parent report were Irritable Bowel Syndrome (IBS; 43–47%) and Abdominal Migraine (26–36%). The most frequent physician diagnoses were Functional Constipation (FC; 53%) and Functional Abdominal Pain (FAP; 29%).

Reliability: Moderate to substantial agreement was found between baseline and 2-week follow-up for most diagnoses (kappa = .19–.78) and between parent and child reports (kappa = −.04–.64).

Validity: There was low agreement between QPGS-RIII and physician diagnosis (kappa =−.02–.34) as well as diaries (kappa = .06–30).

Conclusions & Inferences  The Rome criteria have reasonable test–retest reliability and seem to be inclusive, as the majority of children obtain a diagnosis. However, validity is still an issue: The Rome criteria do not overlap well with physician diagnosis or daily symptoms. These issues will need to be addressed in future revisions of the Rome criteria.