How useful are the Rome II criteria for identification of upper gastrointestinal disorders in general practice?
OBJECTIVE
The Rome II criteria are a classification of functional gastrointestinal disorders. It is not known whether they can be used as a diagnostic tool. This study evaluates the agreement between GPs and the Rome II criteria on the diagnosis of upper gastrointestinal disorders.


METHODS
Consecutive patients with abdominal complaints were included in this pragmatic cross-sectional study. All patients answered a questionnaire based on the Rome II criteria. The diagnoses based on these criteria were compared with the GPs' diagnoses.


RESULTS
A total of 549 consecutively selected patients were included in the study. The agreement between GPs and the Rome II criteria was 65%, kappa 0.34 (CI 0.27-0.41). The agreement was lower when dyspepsia and gastroesophageal reflux/functional heartburn were evaluated separately. The positive and negative predictive values of the Rome II criteria varied between 29-58% and 82-90%, respectively, in various groups of patients with confirmed diagnoses.


CONCLUSIONS
The GPs' diagnoses differed from those based entirely on the Rome II criteria. Strict adherence to the criteria will result in other diseases being disregarded. The diagnoses of upper gastrointestinal disorders should be based on all available information and the Rome II criteria used only as an additional aid to improve the precise classification of functional disorders.
Farup
Per G
PG
Unit for Applied Clinical Research, Norwegian University of Science and Technology, Trondheim, Norway. Per.Farup@ntnu.no
Vandvik
Per O
PO
Aabakken
Lars
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D004415:Dyspepsia / Q000145:classification / Q000175:diagnosis; D005194:Family Practice / Q000592:standards*; D005260:Female; D005764:Gastroesophageal Reflux / Q000145:classification / Q000175:diagnosis; D005767:Gastrointestinal Diseases / Q000145:classification / Q000175:diagnosis*; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011336:Probability; D012424:Rural Population; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014505:Urban Population