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Diagnostic accuracy of the Rome IV Criteria for the Diagnosis of Functional Gastrointestinal Disorders in Children.

ABSTRACT
The diagnosis of functional gastrointestinal disorders (FGIDs) centers on symptoms-based criteria (Rome criteria). The last edition of the criteria was published in 2016. Still, few data on its validity support its use in children. We conducted a study aimed at determining the diagnostic accuracy of the Rome IV criteria through the application of questionnaires (Questionnaire of Pediatric Gastrointestinal Symptoms-Rome IV QPGSIV) to diagnose FGIDS in children. We hypothesized that the Rome IV criteria has adequate diagnostic accuracy supporting its use for diagnosing FGIDs in children.


METHODS
Schoolchildren 10-18 years from Cali (Colombia) completed the Spanish version of the QPGS-IV. Children with FGIDs were matched with a group of children without FGIDs. Both groups had a medical consultation with a blinded experienced pediatric gastroenterologist (gold standard) who provided his diagnosis. The questionnaire-based diagnoses were compared with the consultation's diagnoses.


RESULTS
Of 487 schoolchildren surveyed with the QPGS-IV, 97 (20.8%) had FGIDs. Eighty-nine with FGIDs were matched with 92 children without FGIDs (mean age 13.1 years (± 1.3). We found a higher prevalence of FGIDs during the medical visit than using the self-report QPGS-IV (66.3% vs. 49.2%, p = .001), mainly in abdominal pain disorders (19.3% vs. 10.5%, p = .013). The Rome IV diagnostic criteria using the QPGS-IV had a sensitivity of 75% (95% CI, 59%-79%) and 90% specificity (95% CI, 83%-98%). PPV 85.8%. NPV 79.9%.


CONCLUSION
Our study suggests that the QPGS-IV has adequate diagnostic accuracy.