Symptom-based criteria have been introduced to aid the diagnosis of irritable bowel syndrome.
There is little information about their utility in routine clinical practice, although they have been widely adopted and have proved useful for research purposes by ensuring homogeneity of study populations.
Dr Whorewell and colleagues from England assessed the applicability of the Manning, Rome I and Rome II criteria in the clinical setting.
The researchers wanted to ascertain how often hospital specialists and general practitioners use these diagnostic criteria.
|73% patients with inflammatory bowel disease met Rome II diagnostic criteria with 82% and 94% meeting Rome I and Manning, respectively
The investigators assessed 100 secondary-care patients with inflammatory bowel disease for their conformity to these criteria.
The research team asked 48 hospital specialists and 68 general practitioners about their knowledge and utilization of these criteria.
The team found that 73% patients with inflammatory bowel disease met Rome II diagnostic criteria with 82% and 94% meeting Rome I and Manning, respectively.
Approximately 80% of general practitioners had no knowledge of any of the specific criteria, and only 4% had ever used them.
The researchers also found that the majority of specialists had knowledge of the criteria, with 70% having used them.
The investigative team concluded that the Rome II criteria are remarkably insensitive and if rigidly applied in the clinical situation would lead to much diagnostic uncertainty.
Dr Whorewell concluded that, “The current lack of interest in them, especially amongst general practitioners, is unlikely to change unless they can be considerably improved.”