Pediatric Rome IV diagnosis agreement is greater than agreement on diagnostic testing.
BACKGROUND: Pediatric Rome IV criteria are used to diagnose childhood functional gastrointestinal disorders (FGIDs). This study of pediatric gastroenterology physicians measured their agreement in (1) Making a pediatric Rome IV FGID diagnosis; and (2) Diagnostic testing for patients with FGIDs.
METHODS: Pediatric gastroenterologists and pediatric gastroenterology fellows at two medical centers completed a survey containing clinical FGID vignettes. For each vignette, raters identified the most likely Rome IV diagnosis(es) and selected which diagnostic test(s) (if any) they typically would obtain. The survey was re-administered within 3 months. Inter-rater and intra-rater weighted percent agreement was determined. Linear mixed modeling identified sources of variability in diagnostic testing.
KEY RESULTS: Thirty-four raters completed the initial survey of whom thirty-one (91%) completed the repeat survey. Overall inter-rater agreement on Rome IV diagnoses was 68% for initial and repeat surveys whereas intra-rater agreement was 76%. In contrast, overall inter-rater agreement on diagnostic testing was
CONCLUSIONS & INFERENCES: In a multicenter evaluation among pediatric gastroenterology physicians, pediatric Rome IV diagnostic agreement was higher than that reported for previous Rome versions, and higher than agreement on diagnostic testing.
Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society
abdominal pain; child; diagnosis; disorders of gut-brain interaction; dyspepsia; irritable bowel syndrome
Kaul I, Staggs VS, Bagherian A, et al. Pediatric Rome IV diagnosis agreement is greater than agreement on diagnostic testing. Neurogastroenterol Motil. 2022;34(8):e14355. doi:10.1111/nmo.14355