用于诊断肠脑交互紊乱的儿科罗马IV标准的可靠性

Lee Ginton, Rasmita Budhathoki, Miguel Saps
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We hypothesized that changes made to Rome IV would result in higher IRR than previous versions.MethodsThis study used the same methodology as the previous studies on Rome II and III, including identical clinical vignettes, number of raters, and levels of expertise. Participants included 10 pediatric gastroenterology fellows and 10 pediatric gastroenterology specialists. IRR was assessed using the percentage of agreement and Cohen's kappa coefficient to account for possible agreement by chance.ResultsThe average IRR percentage of agreement using the Rome IV criteria was 55% for pediatric gastroenterologists and 48.5% for fellows, indicating moderate agreement (<jats:italic>k</jats:italic> = 0.54 for specialists, <jats:italic>k</jats:italic> = 0.47 for fellows). The results demonstrated higher percentages of agreement and kappa coefficients compared to the Rome II and III criteria.ConclusionsThe findings demonstrate improved reliability in Rome IV compared to Rome II and III, suggesting that the changes incorporated into the Rome IV criteria have enhanced diagnostic consistency. 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摘要

背景儿童肠脑互动障碍(DGBI)的诊断完全基于临床标准,即罗马标准。评定者之间的可靠性(IRR)衡量两位评定者在使用同一诊断工具进行诊断时达成一致的程度。以前版本的罗马标准只显示出一般到中等的 IRR。目前还没有研究对当前版本的儿科罗马标准(罗马IV)的内部信度进行评估。本研究旨在调查儿科罗马IV标准的内部反应率,并将其可靠性与之前版本的罗马标准进行比较。我们假设,对罗马标准 IV 所做的修改将使其 IRR 高于之前的版本。方法本研究采用了与之前罗马标准 II 和 III 相同的研究方法,包括相同的临床案例、评分者人数和专业水平。参与者包括 10 名儿科胃肠病学研究员和 10 名儿科胃肠病学专家。结果使用罗马IV标准的平均IRR一致率为:儿科胃肠病专家55%,研究员48.5%,表明一致率中等(专家k=0.54,研究员k=0.47)。结论研究结果表明,与罗马 II 和罗马 III 标准相比,罗马 IV 标准的可靠性有所提高,这表明罗马 IV 标准中的变化增强了诊断的一致性。尽管取得了进步,但可靠性仍处于中等水平,这表明需要进一步完善未来版本的罗马标准。
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Reliability of pediatric Rome IV criteria for the diagnosis of disorders of gut–brain interaction
BackgroundThe diagnosis of disorders of gut–brain interaction (DGBI) in children is exclusively based on clinical criteria called the Rome criteria. The inter‐rater reliability (IRR) measures how well two raters agree with a diagnosis using the same diagnostic tool. Previous versions of the Rome criteria showed only fair to moderate IRR. There have been no studies assessing the IRR of the current edition of the pediatric Rome criteria (Rome IV). This study sought to investigate the IRR of the pediatric Rome IV criteria and compare its reliability with the previous versions of the Rome criteria. We hypothesized that changes made to Rome IV would result in higher IRR than previous versions.MethodsThis study used the same methodology as the previous studies on Rome II and III, including identical clinical vignettes, number of raters, and levels of expertise. Participants included 10 pediatric gastroenterology fellows and 10 pediatric gastroenterology specialists. IRR was assessed using the percentage of agreement and Cohen's kappa coefficient to account for possible agreement by chance.ResultsThe average IRR percentage of agreement using the Rome IV criteria was 55% for pediatric gastroenterologists and 48.5% for fellows, indicating moderate agreement (k = 0.54 for specialists, k = 0.47 for fellows). The results demonstrated higher percentages of agreement and kappa coefficients compared to the Rome II and III criteria.ConclusionsThe findings demonstrate improved reliability in Rome IV compared to Rome II and III, suggesting that the changes incorporated into the Rome IV criteria have enhanced diagnostic consistency. Despite the advancements, the reliability is still moderate, indicating the need for further refinement of future versions of the Rome criteria.
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