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Protocol - Assessment of Functional Gastrointestinal Disorders (Adolescent)

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Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Description:

The Questionnaire on Pediatric Gastrointestinal Symptoms—Rome III Version (QPGS-RIII)* is an adaptation and abbreviation of the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS) (Walker, Caplan-Dover, & Rasquin-Weber, 2000; Walker et al., 2005) that was developed with the support of a grant from the Rome Foundation and that has undergone preliminary validation (Caplan, Walker, & Rasquin, 2005a, 2005b). The QPGS-RIII is an adaptation and abbreviation of the original QPGS. It was developed with input from the Rome III Child and Adolescent Committee and the Rome III Questionnaire Committee. Although the format and many items from the original QPGS have been retained, several new items have been included, and the scoring has been revised to reflect changes in symptom criteria based on Rome III. The questionnaire uses five-point scales to measure frequency, severity, and duration of symptoms. In addition, it may be scored to assess whether a patient meets the criteria for each of the individual functional gastrointestinal disorders. The questionnaire is followed by a coding system that identifies provisional diagnoses from the responses to the questions. The QPGS-RIII cannot substitute for the medical evaluation and clinical judgment required for an accurate diagnosis. *Developed by Lynn S. Walker, Arlene Caplan, and Andree Rasquin.

Protocol:

Summary of the Questionnaire on Pediatric Gastrointestinal Symptoms—Rome III Version (QPGS-RIII)

This questionnaire asks adolescents about their digestive system (esophagus, stomach, small intestine, and colon) and problems associated with it. Questions are asked about pain and uncomfortable feelings above, below, and around the belly button area that they may have had in the last 2 months. There are also sections that ask about bowel movements and other symptoms.

Scoring Instructions

Scoring information is available as part of the questionnaire. Items are labeled by section (e.g., A1 is item #1 in Section A of the QPGS-RIII). For each disorder, the patient must meet the criteria for all items indicated. Cut-points for symptom frequencies to meet diagnostic criteria are based on provisional recommendations by the Rome III Child and Adolescent Committee.

Personnel and Training Required

None

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Adolescent

Specific Instructions:

This questionnaire is designed to administer to adolescents aged 10-17 years old. Please see the adult or child version of this questionnaire, as appropriate. The Gastrointestinal Working Group recommends performing serology for celiac sprue in patients with diarrhea.
Research Domain Information

Release Date:

December 13, 2010

Definition

Questionnaire that asks about gastrointestinal symptoms to help identify the presence of functional gastrointestinal disorders (FGIDs) and their subtypes.

Purpose

This measure is used to help determine the presence of functional gastrointestinal disorders (FGIDs), such as functional bowel disorders (e.g., irritable bowel syndrome, functional constipation, functional diarrhea, functional abdominal pain, and functional bloating), functional gastroduodenal disorders (e.g., functional dyspepsia, functional nausea, functional vomiting), functional esophageal disorders (e.g., functional heartburn, functional dysphagia), and others.

Selection Rationale

This questionnaire is based on the commonly used Rome III symptom-based diagnostic criteria, which was developed by consensus from a group of experts in the field of functional gastrointestinal disorders (FGIDs).

Language

English

Standards

StandardNameIDSource
Common Data Elements (CDE)Adolescent Gastrointestinal Disorder Assessment Score3163044CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Assess func GI disorders adoles proto62952-7LOINC

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

Questionnaire on Pediatric Gastrointestinal Symptoms, Rome III Version (QPGS-RIII). (Adapted from the Questionnaire on Pediatric Gastrointestinal Symptoms; Walker, Caplan-Dover, & Rasquin-Weber, 2000.)

The Rome III questionnaires are available to view online at: http://www.romecriteria.org/questionnaires/

For copyright policy and licensing fee schedules for translations and usage of the Rome III questionnaires, please contact Michele Pickard at: mpickard@theromefoundation.org

General References

Caplan, A., Walker, L. S., & Rasquin, A. (2005). Development and preliminary validation of the Questionnaire on Pediatric Gastrointestinal Symptoms to assess functional gastrointestinal disorders in children and adolescents. Journal of Pediatric Gastroenterology Nutrition, 4, 296–304.

Caplan, A., Walker, L. S., & Rasquin, A. (2005). Validation of the Pediatric Rome II Criteria for functional gastrointestinal symptoms using the Questionnaire on Pediatric Gastrointestinal Symptoms. Journal of Pediatric Gastroenterology Nutrition, 41, 305–316.

Drossman, D. A. (2006). Rome III: The functional gastrointestinal disorders (3rd ed.). McLean, VA: Degnon Associates.

Drossman, D. A. (2006). The functional gastrointestinal disorders and the Rome III process. Gastroenterology, 130, 1377–1390.

Walker, L. S., Caplan, A., & Rasquin, A. (2000). Manual for the Questionnaire on Pediatric Gastrointestinal Symptoms. Nashville, TN: Department of Pediatrics, Vanderbilt University Medical Center.

Walker, L. S., Lipani, T. A., Greene, J. W., Caines, K., Stutts, J., Polk, D. B., Caplan, A., & Rasquin-Weber, A. (2004). Recurrent abdominal pain: Subtypes based on the Rome II criteria for pediatric functional gastrointestinal disorders. Journal of Pediatric Gastroenterology Nutrition, 38, 187–191.

Protocol ID:

190102

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX190102000000Protocol 190102 - proprietary. Check DCW for contact.4N/A