Original ResearchFull Report: Clinical-Alimentary TractThe Rome III Criteria for the Diagnosis of Functional Dyspepsia in Secondary Care Are Not Superior to Previous Definitions
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Participants and Setting
This study was conducted among patients newly referred from primary care to secondary care for consideration of investigation of upper or lower GI symptoms. Unselected consecutive new patients aged 16 years and older were approached in the GI outpatient clinics of McMaster University Medical Center or St. Joseph's Healthcare, 2 hospitals in Hamilton, Ontario, serving a local population of 520,000. During a monitoring period from January 2012 to December 2012, 26% of the referrals to the clinics
Results
There were a total of 4224 consecutive new patients who provided informed consent and were recruited into the study between January 2008 and December 2012 (Figure 1). The mean age of recruited subjects was 47.6 years (range, 16-93 y), and 2617 (62.0%) were female. In total, 1605 (38.0%) of these 4224 patients underwent complete endoscopic evaluation for their upper GI symptoms. The mean age among those undergoing upper GI endoscopy was 48.9 years (range, 16-91 y), and 1018 (63.4%) were female.
Discussion
This study attempted to validate the Rome III criteria for FD against an accepted reference standard. It has been shown that these criteria perform only modestly in predicting a diagnosis of FD in a patient with upper GI symptoms, with their presence increasing the likelihood of having FD by approximately 2-fold, while their absence reduces the likelihood of FD by approximately 40%. When the individual symptom subtypes of EPS and PDS were examined, the presence of EPS increased the likelihood
Acknowledgments
The authors are grateful to June Urquhart for entry of questionnaire data and administering questionnaires to clinic patients, and Sandra Arthur for administering questionnaires to clinic patients.
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This article has an accompanying continuing medical education activity on page e14. Learning Objective: Upon completion of this CME activity, successful learners will be able to recognize conditions that cause dyspepsia, as well as judge the utility of various diagnostic criteria in predicting a diagnosis of functional dyspepsia.
Conflicts of interest The authors disclose the following: Premysl Bercik is a recipient of a Hamilton Health Sciences Early Career Award. The remaining authors disclose no conflicts.
Funding Supported by the Canadian Association of Gastroenterology. The study sponsor had no role in the study design, collection, analysis, or interpretation of data.