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Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria.
Scand J Gastroenterol 2004; 39(5):448-53SJ

Abstract

BACKGROUND

The new guidelines for diagnosing irritable bowel syndrome (IBS) in clinical practice recommend the use of the Rome II criteria. In this study the agreement between general practitioners (GPs) and the Rome II criteria for diagnosing of IBS and functional bowel disorders (FBD) is examined.

METHODS

Consecutive patients in general practice were asked to report on abdominal complaints, for which they had consulted or wanted to consult a GP. Patients with such complaints completed a questionnaire based on the Rome II criteria for FBD. After consultations, the GPs reported their diagnoses on the abdominal complaints.

RESULTS

Of 3097 screened patients, 553 patients were diagnosed by their GP and had complete data in the questionnaire. Of these patients, 107 had IBS according to the GPs and 209 had IBS according to the Rome II criteria (agreement 58%, kappa 0.01 (CI: -0.06; 0.09)). Agreement on IBS and FBD in patients without organic disease, without reflux or dyspepsia and in patients with a verified diagnosis was 45%-58%, with kappa values from -0.02 to 0.13. IBS and FBD cases were diagnosed by the Rome II criteria more often than by the GPs in all these groups of patients (P < 0.001). In patients with diagnostic discrepancies concerning IBS, 'stress-related symptoms' was predictive of a diagnosis of IBS made by the GPs only (OR 2.17 (CI: 1.1; 4.2)).

CONCLUSIONS

This study shows poor agreement in the diagnosis of IBS between GPs and the Rome II criteria. Therefore, current knowledge about IBS based on strict criteria is not necessarily transferable to patients with IBS in general practice.

Authors+Show Affiliations

Dept. of Medicine, Innlandet Hospital Health Authority, Gjøvik, Norway. per.vandvik@start.noNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15180182

Citation

Vandvik, P O., et al. "Diagnosing Irritable Bowel Syndrome: Poor Agreement Between General Practitioners and the Rome II Criteria." Scandinavian Journal of Gastroenterology, vol. 39, no. 5, 2004, pp. 448-53.
Vandvik PO, Aabakken L, Farup PG. Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria. Scand J Gastroenterol. 2004;39(5):448-53.
Vandvik, P. O., Aabakken, L., & Farup, P. G. (2004). Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria. Scandinavian Journal of Gastroenterology, 39(5), pp. 448-53.
Vandvik PO, Aabakken L, Farup PG. Diagnosing Irritable Bowel Syndrome: Poor Agreement Between General Practitioners and the Rome II Criteria. Scand J Gastroenterol. 2004;39(5):448-53. PubMed PMID: 15180182.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria. AU - Vandvik,P O, AU - Aabakken,L, AU - Farup,P G, PY - 2004/6/8/pubmed PY - 2004/10/20/medline PY - 2004/6/8/entrez SP - 448 EP - 53 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 39 IS - 5 N2 - BACKGROUND: The new guidelines for diagnosing irritable bowel syndrome (IBS) in clinical practice recommend the use of the Rome II criteria. In this study the agreement between general practitioners (GPs) and the Rome II criteria for diagnosing of IBS and functional bowel disorders (FBD) is examined. METHODS: Consecutive patients in general practice were asked to report on abdominal complaints, for which they had consulted or wanted to consult a GP. Patients with such complaints completed a questionnaire based on the Rome II criteria for FBD. After consultations, the GPs reported their diagnoses on the abdominal complaints. RESULTS: Of 3097 screened patients, 553 patients were diagnosed by their GP and had complete data in the questionnaire. Of these patients, 107 had IBS according to the GPs and 209 had IBS according to the Rome II criteria (agreement 58%, kappa 0.01 (CI: -0.06; 0.09)). Agreement on IBS and FBD in patients without organic disease, without reflux or dyspepsia and in patients with a verified diagnosis was 45%-58%, with kappa values from -0.02 to 0.13. IBS and FBD cases were diagnosed by the Rome II criteria more often than by the GPs in all these groups of patients (P < 0.001). In patients with diagnostic discrepancies concerning IBS, 'stress-related symptoms' was predictive of a diagnosis of IBS made by the GPs only (OR 2.17 (CI: 1.1; 4.2)). CONCLUSIONS: This study shows poor agreement in the diagnosis of IBS between GPs and the Rome II criteria. Therefore, current knowledge about IBS based on strict criteria is not necessarily transferable to patients with IBS in general practice. SN - 0036-5521 UR - https://www.unboundmedicine.com/medline/citation/15180182/Diagnosing_irritable_bowel_syndrome:_poor_agreement_between_general_practitioners_and_the_Rome_II_criteria_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520310008782 DB - PRIME DP - Unbound Medicine ER -