Irritable bowel syndrome: what do the new Rome IV diagnostic guidelines mean for patient management?

Figures & data

Table 1. Diagnostic accuracy of Rome IV compared to Rome III criteria.

Test statistic	Rome IV	Rome III
Sensitivity	.627	.731
Specificity	.971	.931
Positive likelihood ratio (PLR)^a	21.6	10.6
Negative likelihood ratio (NLR)^b	.384	.289

^aThe PLR is defined as sensitivity/(1-specificity) [7]. Larger numbers reflect a greater likelihood that a positive finding on the diagnostic test is associated with true disease.

^bThe NLR is defined as (1-sensitivity)/specificity. Smaller numbers reflect greater likelihood that a negative finding on a diagnostic test is associated with absence of disease.

Ford AC, Talley NJ, Veldhuyzen van Zanten SJ, et al. Will the history and physical examination help establish that irritable bowel syndrome is causing this patient’s lower gastrointestinal tract symptoms? Jama. 2008;300:1793–1805.

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