Exploring the agreement between diagnostic criteria for IBS in primary care in Greece

被引：5

作者：

Anastasiou F. ^{[1
]}

Mouzas I.A. ^{[2
]}

Moschandreas J. ^{[3
]}

Kouroumalis E. ^{[2
]}

Lionis C. ^{[1
]}

机构：

[1] Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete

[2] Department of Gastroenterology, University Hospital of Heraklion, Heraklion, Crete

[3] Biostatistics Laboratory, Department of Social Medicine, University of Crete, Heraklion, Crete

来源：

BMC Research Notes | / 1卷 / 1期

关键词：

Primary Care; Irritable Bowel Syndrome; Dyspepsia; Irritable Bowel Syndrome Patient; Functional Gastrointestinal Disorder;

D O I：

10.1186/1756-0500-1-127

中图分类号：

学科分类号：

摘要：

Background. Irritable Bowel Syndrome (IBS) is frequently diagnosed in primary care. Its diagnosis is based on diagnostic criteria but their use is limited in primary care. We aimed to assess the diagnostic agreement between the older (Manning's and Rome II) and the new (Rome III) criteria for the diagnosis of IBS in primary care in Greece. Methods. Medical records of 5 Health Centers in rural Crete, Greece, were reviewed for a four-year period and patients with the diagnosis of IBS were invited to a structured interview. Kappa agreement of the Rome III criteria with the criteria of Manning and Rome II was estimated. One hundred and twenty three patients were eligible for interview and 67 (54.5%) participated. Forty-six (69%) fulfilled the Manning, 32(48%) the Rome II, and 16(24%) the Rome III criteria. Twenty-seven (40%) patients were identified as IBS according to the questionnaire for the identification of functional gastrointestinal diseases (FGIDs). The agreement of Rome III with Manning criteria was poor (kappa = 0.25). The agreement between the FGIDs questionnaire and the Manning, Rome II and Rome III criteria was: kappa = 0.30, 0.31 and 0.24 respectively. Moderate agreement was found between the Rome II and III criteria (kappa = 0.51). Conclusion. Questionnaires and criteria deriving from expert's consensus meetings or tertiary hospitals are not easy to apply in rural primary care where symptoms are often underestimated by patients and complicated questions can be confusing. © 2008 Anastasiou et al; licensee BioMed Central Ltd.

引用

共 28 条

[1]

Thompson W.G., Heaton K.W., Smyth G.T., Smyth C., Irritable bowel syndrome in general practice: Prevalence, characteristics, and referral, Gut, 46, 1, pp. 78-82, (2000)

[2]

Manning A.P., Thompson W.G., Heaton K.W., Morris A.F., Towards positive diagnosis of the irritable bowel, Br Med J, 2, 6138, pp. 653-654, (1978)

[3]

Talley N.J., Stanghellini V., Heading R.C., Koch K.L., Malagelada J.R., Tytgat G.N.J., Rome II: A Multinational Consensus Document on Functional Gastrointestinal Disorders, Functional gastroduodenal disorders, Gut, 45, SUPPL. 2, (1999)

[4]

Tack J., Talley N.J., Camilleri M., Holtmann G., Hu P.J., Malagelada J.-R., Stanghellini V., Functional Gastroduodenal Disorders, Gastroenterology, 130, pp. 1466-1479, (2006)

[5]

Vandvik P.O., Aabakken L., Farup P.G., Diagnosing irritable bowel syndrome: Poor agreement between general practitioners and the Rome II criteria, Scand J Gastroenterol, 39, pp. 448-453, (2004)

[6]

Lea R., Hopkins V., Hastleton J., Houghton L.A., Whorwell P.J., Diagnostic criteria for irritable bowel syndrome: Utility and applicability in clinical practice, Digestion, 70, pp. 207-209, (2004)

[7]

Spiegel M.R., Do physicians follow evidence-based guidelines in the diagnostic work-up of IBS?, Nat Clin Pract Gastroenterol Hepatol, 4, pp. 296-297, (2007)

[8]

Lionis C., Olsen-Faresjo A., Anastasiou F., Wallander M.A., Johansson S., Faresjo T., Measuring the frequency of functional gastrointestinal disorders in rural Crete: A need for improving primary care physicians' diagnostic skills, Rural Remote Health, 5, (2005)

[9]

Papatheodoridis G.V., Karamanolis D.G., Prevalence and impact of upper and lower gastrointestinal symptoms in the Greek urban general population, Scand J Gastroenterol, 40, pp. 412-421, (2005)

[10]

Kennedy T., Jones R., Development of a postal health status questionnaire to identify people with dyspepsia in the general population, Scand J Prim Health Care, 13, pp. 243-249, (1995)

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