Abstract General Information

Title

ACCURACY BETWEEN ROME IV AND INSTRUMENTS TO ASSESS FUNCTIONAL CONSTIPATION – CONSTIPATION SCORE, RECTAL DIAMETER, BRISTOL SCALE, AND DYSFUNCTIONAL VOIDING SCORING SYMPTOM – IN CHILDREN AND ADOLESCENTS

Introduction and objective

To assess the accuracy between the Rome IV criteria (RC IV) and instruments used to diagnose functional constipation (FC) in children and adolescents.

Method

In children and adolescents aged between 5 and 17 years, the RC IV and instruments that also measure FC were applied - Cleveland Clinic Constipation Score adapted for children (CCS), Rectal diameter (RD), Bristol Scale (BS), and questions 3 and 4 of the Dysfunctional Voiding Scoring Symptom (3 DVSS and 4 DVSS). The RC IV was the gold standard instrument (FC = ≥ 2 positive items). The agreement was evaluated by the Roc curve.

Results

118 children and adolescents with a median age of 8 (IQR 6 -11) were evaluated, including 60 (50.8%) boys. Eighty-three (70.3%) were constipated. The agreement analysis showed BS kappa = 0.067, p=0.33; RD kappa = 0.007, p = 0.927; 3 DVSS kappa = 0.187, p=0.039; 4 DVSS Kappa = 0.416, p < 0.001; 3 DVSS plus 4 DVSS kappa = 0.231, p=0.005; CCS sensitivity = 78.31%, specificity = 88.57% (associated criterion >6, area under the Roc curve=0.908, p=0.0001) and RD sensitivity = 42.86%, specificity = 91.30% (associated criterion ≤ 1.9, area under the Roc curve = 0.540, P=0.803).

Conclusion

The CCS is an instrument with good accuracy for the diagnosis of CF, and can be used as a diagnostic instrument for CF. In turn, the DVSS has a low agreement and the BS and RD instruments do not show agreement. Therefore, they cannot replace the RC IV.