Diagnosing irritable bowel syndrome: poor agreement between general practitioners and the Rome II criteria.
Scand J Gastroenterol
; 39(5): 448-53, 2004 May.
Article
em En
| MEDLINE
| ID: mdl-15180182
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.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Guias de Prática Clínica como Assunto
/
Síndrome do Intestino Irritável
/
Medicina de Família e Comunidade
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Scand J Gastroenterol
Ano de publicação:
2004
Tipo de documento:
Article
País de afiliação:
Noruega