Predictive value of the rome criteria for diagnosing the irritable bowel syndrome
Predictive value of the rome criteria for diagnosing the irritable bowel syndrome
复制标题
罗马标准诊断肠易激综合征的预测价值
DOI：
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发表时间：
1999
影响因子：
9.8
通讯作者：
M. Djurfeldt
中科院分区：
文献类型：
--
作者：
S. Vanner;W. Depew;W. Paterson;L. Dacosta;A. Groll;J. B. Simon;M. Djurfeldt
目的：我们的目的是检验罗马标准的预测价值以及诊断肠易激综合征临床实践中是否存在所谓的“危险信号”。危险信号是体检、记录的体重减轻、夜间症状、便血、抗生素使用史和结肠癌家族史的相关异常。方法：在回顾性研究中，通过一年期的图表审查确定了 98 名具有一项或多项罗马标准且缺乏危险信号的患者。在前瞻性研究中，确定了 95 名符合罗马标准且没有危险信号的患者。确定了罗马标准的敏感性、特异性、预测价值以及是否存在危险信号。顾问的最终诊断是金标准。记录转诊前后的调查，并在前瞻性研究中确定转诊原因。 结果：在回顾性系列中，罗马标准和无危险信号的敏感性为 65%，特异性为 100%，阳性预测值为 100%。在两年的随访期间，这些患者均不需要修改诊断。在前瞻性研究中，阳性预测值为98%。该组中超过 50% 的患者因诊断不确定而被转诊，24% 的患者接受了腹部超声检查； 66% 的 45 岁以下患者至少接受了部分结肠评估。结论：这些研究结果表明，罗马标准加上缺乏危险信号对于诊断肠易激综合征具有非常高的预测价值。这些诊断标准的应用有可能改变医疗保健资源的利用。
Objective:Our aim was to examine the predictive value of the Rome criteria and absence of so-called “red flags” of clinical practice for diagnosing irritable bowel syndrome. Red flags were relevant abnormalities on physical examination, documented weight loss, nocturnal symptoms, blood in stools, history of antibiotic use, and family history of colon cancer.Methods:In retrospective studies, 98 patients who had one or more Rome criteria and lacked red flags were identified by chart review of a 1-yr period. In prospective studies, 95 patients were identified who met the Rome criteria and lacked red flags. Sensitivity, specificity, predictive value of Rome criteria, and absence of red flags were determined. Consultant's final diagnosis was the gold standard. Investigations before and after referral were recorded and reason for referral was determined in prospective studies.Results:In the retrospective series, the Rome criteria and absence of red flags had a sensitivity of 65%, specificity of 100%, and positive predictive value of 100%. None of these patients required revision of their diagnosis during a 2-yr follow-up. In the prospective study, the positive predictive value was 98%. More than 50% of the patients in this group had been referred because of diagnostic uncertainty and 24% had had an abdominal ultrasound; 66% of those <45 yr old underwent at least partial colonic evaluation.Conclusion:These findings suggest that the Rome criteria combined with a lack of red flags have a very high predictive value for diagnosing irritable bowel syndrome. Application of these diagnostic criteria has the potential to alter utilization of health care resources.
影响因子：
29.4
作者：
TALLEY, NJ;GABRIEL, SE;EVANS, RW
通讯作者：
EVANS, RW