ArticleThe American journal of gastroenterology2016
Enhancing Diagnostic Performance of Symptom-Based Criteria for Irritable Bowel Syndrome by Additional History and Limited Diagnostic Evaluation.
Article in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Guideline
- Second-Generation Biomarker Testing for Irritable Bowel Syndrome Using Plasma Anti-CdtB and Anti-Vinculin Levels.Digestive diseases and sciences · 2019Trial
- Progresses in Wound Healing: Integrating Nutrition, Physical Therapy, Traditional and Alternative Medicine, and Novel Technologies.Current diabetes reviews · 2026Review
- Clinical practice guidelines for the diagnosis of constipation-predominant irritable bowel syndrome and functional constipation in adults: a scoping review.BMC gastroenterology · 2025Article
- Validating Simple Modifications to the Rome IV Criteria for the Diagnosis of Irritable Bowel Syndrome in Secondary Care.Alimentary pharmacology & therapeutics · 2025Article
- Moving beyond Symptom Criteria to Diagnose and Treat Functional Disorders: Patient-Reported Symptoms of Functional Lower Gastrointestinal Disorders Correlate Poorly with Objective Assessment of Luminal Contents Seen on Intestinal Ultrasound.Journal of clinical medicine · 2024Article
- A Case Study in the IBS-C Management Continuum: Assessing Patient Response and Tailoring Treatment.Gastroenterology & hepatology · 2024Article
- Raising the Bar in the Management of IBS-C.Gastroenterology & hepatology · 2023Article
- Supplementation With Bifidobacterium and Symptomatic Control in Irritable Bowel Syndrome: An Evidence-Based Review.Cureus · 2023Review
- Editorial: Advances in research on the role of inflammation in gut functional disorders.Frontiers in physiology · 2023Article
- Multiple rather than specific autoantibodies were identified in irritable bowel syndrome with HuProt™ proteome microarray.Frontiers in physiology · 2022Article
- Irritable Bowel Syndrome: Straightening the road from the Rome criteria.Neurogastroenterology and motility · 2020Review
- Rational investigations in irritable bowel syndrome.Frontline gastroenterology · 2020Article
- Overlapping of irritable bowel syndrome with erosive esophagitis and the performance of Rome criteria in diagnosing IBS in a clinical setting.Molecular medicine reports · 2019Article
- Canadian Association of Gastroenterology Clinical Practice Guideline for the Management of Irritable Bowel Syndrome (IBS).Journal of the Canadian Association of Gastroenterology · 2019Article
- Quality of Care and the Irritable Bowel Syndrome: Is Now the Time to Set Standards?The American journal of gastroenterology · 2018Article
- Making a positive diagnosis of irritable bowel syndrome.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice.United European gastroenterology journal · 2017Review
- The global impact of IBS: time to think about IBS-specific models of care?Therapeutic advances in gastroenterology · 2017Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesSymptom-based criteria to diagnose irritable bowel syndrome (IBS) positively perform only modestly. Our aim was to assess whether including other items from the clinical history and limited diagnostic evaluation improves their performance.
methodsWe collected complete symptom, colonoscopy, and histology data from 318 consecutive, unselected adult patients with lower gastrointestinal (GI) symptoms in secondary care. All participants underwent colonoscopy, with relevant organic findings recorded. The reference standard used to define the presence of true IBS was patient-reported lower abdominal pain or discomfort associated with a change in bowel habit, in the absence of organic GI disease. Sensitivity, specificity, and positive and negative likelihood ratios (LRs), with 95% confidence intervals, were calculated for Rome III criteria, as well as for modifications, incorporating nocturnal stools, results of simple blood tests (hemoglobin and C-reactive protein (CRP)), measures of somatization, and/or affective disorders (hospital anxiety or depression scale (HADS) score).
resultsThe sensitivity and specificity of the Rome III criteria for identifying IBS was 69.6%, and 82.0%, respectively, with positive and negative LRs of 3.87 and 0.37, respectively. Clinically useful enhancements in positive LRs were provided by combining Rome III criteria with: (a) high level of somatization (7.27); (b) normal hemoglobin and CRP with HADS score of ≥8 (5.04); (c) normal hemoglobin and CRP with a high level of somatization (7.56); or (d) no nocturnal passage of stool with a high level of somatization (17.3). Specificity was ≥95% with each of these modifications.
conclusionsIncorporating nocturnal stools, somatization, and affective disorders from the clinical history, and hemoglobin and CRP measurements, enhances the positive LR and specificity of symptom-based Rome III criteria for IBS.
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