Competitive Research Award
The Rome Foundation established a Research Committee in January 2007, chaired by William Whitehead and Enrico Corazziari. The Research committee is responsible for developing guidelines, overseeing the process, and monitoring progress of research grants awarded by the Foundation. One or more awards of up to $50,000 will be given annually. Preference will be given to applications that (1) test the validity and/or utility of the Rome III diagnostic criteria, (2) assess the epidemiology of functional GI and motility disorders, or (3) advance knowledge of outcome assessment or trial design for FGID treatment trials.
In 2008, the first award was given to Dr. Madhulika Varma for her work on "Comprehensive validation of the Rome III constipation module". In 2009, the Rome Foundation is pleased to give this award to Dr. Miranda van Tilburg for her work on "Validation of the Child/Adolescent Rome III Criteria".
2009 Rome Foundation Research Grant
Miranda Van Tilburg, PhD
Miranda Van Tilburg, PhD
Assistant Professor of Medicine
University of North Carolina
Dr. van Tilburg is an assistant professor of medicine at the UNC Center for Functional GI & Motility in the Division of Gastroenterology and Hepatology at the University of North Carolina at Chapel Hill. She received her Master's degree in Economic Psychology and her PhD in Health Psychology at Tilburg University, The Netherlands. In 2001, she completed a three-year postdoctoral fellowship in Endocrinology and Medical Psychology at Duke University Medical Center. For her work she was awarded the 2007 Pediatric Junior Investigator Award of the International Foundation for Functional Gastrointestinal Disorders (IFFGD) and a 2008 IFFGD Research Grant.
Validation of the Child/Adolescent Rome III Criteria
Background: Establishment of symptom-based criteria for pediatric functional gastrointestinal disorders(FGID) by the Rome committee in 1999 considerably advanced the diagnosis and study of children who suffer from functional gastrointestinal symptoms. The Rome criteria have been helpful in distinguishing subgroups of children with FGIDs and a handful of studies have shown initial validation of these criteria in a pediatric population but several problems were identified as well. The new Rome III criteria aimed to resolve most of these problems.
Aims: Functional gastrointestinal disorders are very common in children with about 17% of children suffering from abdominal pain of functional origin or constipation. Development of the Rome criteria to diagnose functional gastrointestinal disorders in children and adolescents has been of great importance to research and clinical practice. Some problems with the Rome II criteria have been identified. Perhaps the most significant finding was that up to one third of children with a physician diagnosis of functional abdominal pain does not meet Rome criteria. The Rome committee has revised the criteria recently to be more inclusive and to adjust several other problems that were identified. There is currently no data that shows if the Rome III criteria identify more children with a functional gastrointestinal disorder.
The aim of the present study is to validate the Rome III criteria in a population of children with functional gastrointestinal disorders:
- Aim #1: Validate the Rome III criteria against physician diagnosis and daily diaries. Because of the expected low rates of some Rome III disorders the study will only be powered to validate the most common child/adolescent disorders including Functional Dyspepsia, Irritable Bowel Syndrome and Functional Constipation. Data on other disorders will be collected to yield descriptive data.
- Aim #2: Assess the stability of the Rome III diagnoses, (test-retest reliability)
- Aim #3: Determine concordance between parent-child report.
Methods: We plan to recruit 105 children between the ages of 4 and 18 years old and their primary caregiver who present at the pediatric gastroenterology clinics at UNC hospitals and Duke University Medical Center for gastrointestinal symptoms. Caregivers and children age 10 and up will complete the Questionnaire on Pediatric Gastrointestinal Symptoms (QPGS) while in the clinic. Half the families will be asked to complete the QPGS 2 weeks later while the other half will be asked to complete daily diaries. Physician diagnoses will be retrieved from the medical records. We will assess test-retest reliability and determine concordance between caregiver-child report. We will validate the questionnaire against daily diaries, and physician diagnosis. An exploratory aim will be to review if caregiver-child disagreement is due to inaccuracies in caregiver report of stool symptoms (non-observable behavior) and/or child report of pain (non saliency). We will also explore whether child or caregiver recall of pain and stool pattern is most accurate at different ages.