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====== Irritable Bowel Syndrome (IBS) diagnostic score ======

Researchers from the [[https://www.rug.nl/staff/r.tendeiro-monden/|University Medical Center Groningen]] developed a Irritable Bowel Syndrome (IBS) diagnostic score for adult participants using [[functional_bowel_symptoms_rome_iii
|ROME III variables]] from [[2a_questionnaire_2|2A Questionnaire 2]] and [[3a_questionnaire_1|3A Questionnaire 1]]. ([[sections]]: [[Diseases & symptoms]] ([[Functional Bowel Symptoms (Rome III)]]) and [[secondary & linked variables]]).\\

The IBS diagnostic score can be requested in the Lifelines catalogue or by mail (data@lifelines.nl).\\
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===== Background =====
To identify participants with a positive Irritable Bowel Syndrome (IBS) diagnostic score based on the ROME III the researchers used the article from [[https://doi.org/10.1053/j.gastro.2006.03.008|Drossman, D. A. (2006)]]. In contrast to the article one criteria with respect to the occurrence of symptoms was adjusted in accordance to the ROME III of Lifelines, i.e. participants should indicate that they have recurrent abdominal pain or discomfort at least 1 day per week (instead of 3 days per month), with a symptom onset at least 6 months in the past. For women, this abdominal pain or discomfort should not only occur during menstrual bleeding. 
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===== Calculation of IBS diagnostic score =====
To identify participants who get a positive Irritable Bowel Syndrome (IBS) diagnostic score, part of the ROME III is taken into consideration. More specifically, participants have to meet four specific criteria in order to receive the IBS diagnostic score. In other words, if all criteria are met the participant receives a positive diagnostic score and when at least one of the criteria is zero the participant receives a negative IBS diagnostic score. 
Below the four criteria are highlighted including details on the included statements in the calculation.

=== 1. Having recurrent abdominal pain or discomfort at least 1 day per week ===
| **IF...** | **THEN...** |
|rome3_discomfort_adu_q_01>=5|RomeCriteria1=1|
|rome3_discomfort_adu_q_01<=4|RomeCriteria1=0|.

=== 2. Symptom duration for at least 6 months ===
| **IF...** | **THEN...** |
|rome3_discomfort_adu_q_03_a OR rome3_discomfort_adu_q_03_b is filled|'auxiliary variable'=0|
|rome3_discomfort_adu_q_03_a (in months) plus rome3_discomfort_adu_q_03_b >=6|'auxiliary variable'=1|
|rome3_discomfort_adu_q_03=1 OR 'auxiliary variable'=1|RomeCriteria2=1|
|RomeCritaria2=MISSING AND (rome3_discomfort_adu_q_03=2 OR 'auxiliary variable'=0)|RomeCriteria2=0|

=== 3. At least two out of three additional symptoms ===
The three additional symptoms that are considered are: pain improvement with defecation (A), onset associated with a change in frequency of stool (B), and onset associated with a change in form (appearance) of stool (C).
| **IF...** | **THEN...** |
|rome3_discomfort_adu_q_04>=2|RomeCriteria1A=1|
|rome3_discomfort_adu_q_04=1|RomeCriteria1A=0|
|rome3_discomfort_adu_q_05>=2|RomeCriteria1B1=1|
|rome3_discomfort_adu_q_05=1|RomeCriteria1B1=0|
|rome3_discomfort_adu_q_06>=2|RomeCriteria1B2=1|
|rome3_discomfort_adu_q_06=1|RomeCriteria1B2=0|
|RomeCriteria1B1=1 OR RomeCriteria1B2=1|RomeCriteria1B=1|
|RomeCriteria1B1+RomeCriteria1B2=0|RomeCriteria1B=0|
|rome3_discomfort_adu_q_07>=2|RomeCriteria1C1=1|
|rome3_discomfort_adu_q_07=1|RomeCriteria1C1=0|
|rome3_discomfort_adu_q_08>=2|RomeCriteria1C2=1|
|rome3_discomfort_adu_q_08=1|RomeCriteria1C2=0|
|RomeCriteria1C1=1 OR RomeCriteria1C2=1|RomeCriteria1C=1|
|RomeCriteria1C1+RomeCriteria1C2=0|RomeCriteria1C=0|
|RomeCriteria1A+RomeCriteria1B+RomeCriteria1C>=2|Sumscore1ABC=1|
|one of three criteria is missing AND the other two are 1 (1A,1B,1C)|Sumscore1ABC=1|
|one of three criteria is missing AND the other two are 0 (1A,1B,1C)|Sumscore1ABC=0|
|RomeCriteria1A+RomeCriteria1B+RomeCriteria1C<2|Sumscore1ABC=0|

=== 4. Abdominal pain or discomfort should not only occur during menstrual bleeding by women ===
| **IF...** | **THEN...** |
|rome3_discomfort_adu_q_02>=2 AND GENDER="FEMALE"|Rome2_adjusted=1|
|rome3_discomfort_adu_q_02<2 AND GENDER="FEMALE"|Rome2_adjusted=0|
|GENDER="MALE"|Rome2_adjusted=1|
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===== Variables =====
| **Label English**                                                         | **Label Dutch**                                                              | **Code**           | **Variable**  | **Assessment**                                       | **Age**  |
| Participant fulfills ROME3 criteria for Irritable Bowel Syndrome (IBS)  | Deelnemer voldoet aan ROME3 criteria voor prikkelbare darm syndroom (PDS)  | ibs_rome3_adu_c_1  | IBS_ROME3     | [[2a_questionnaire_2|2A]] [[3a_questionnaire_1|3A]]  | 18+      |
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===== Publications =====
  * [[https://doi.org/10.1126/scitranslmed.aap8914|Vila, A. V., Imhann, F., Collij, V., Jankipersadsing, S. A., Gurry, T., Mujagic, Z., ... & Weersma, R. K. (2018). Gut microbiota composition and functional changes in inflammatory bowel disease and irritable bowel syndrome. Science translational medicine, 10(472).]]
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