TY - JOUR
T1 - Factor Analysis Defines Distinct Upper and Lower Gastrointestinal Symptom Groups Compatible With Rome IV Criteria in a Population-based Study
AU - Clevers, Egbert
AU - Whitehead, William E.
AU - Palsson, Olafur S.
AU - Sperber, Ami D.
AU - Törnblom, Hans
AU - Van Oudenhove, Lukas
AU - Tack, Jan
AU - Simrén, Magnus
N1 - Funding Information:
Conflicts of interest These authors disclose the following: William E. Whitehead received research grants from Ironwood Pharmaceuticals, Takeda Pharmaceuticals, Salix Pharmaceuticals, and the Rome Foundation; and is a consultant to Ono Pharma USA. Olafur S. Palsson received research grants from Ironwood Pharmaceuticals, Takeda Pharmaceuticals, Salix Pharmaceuticals, and the Rome Foundation. Hans Törnblom has served as consultant/advisory board member for Almirall and Allergan; and as a speaker for Tillotts, Takeda, Shire, and Almirall. Lukas Van Oudenhove has received grant support from Abide Therapeutics and Nestlé; and has given scientific advice to Grünenthal. Jan Tack has given scientific advice to Abide Therapeutics, AlfaWassermann, Allergan, Christian Hansen, Danone, Genfit, Ironwood, Janssen, Kiowa Kirin, Menarini, Mylan, Novartis, Nutricia, Ono Pharma, Rhythm, Shionogi, Shire, SK Life Sciences, Takeda, Theravance, Tsumura, Yuhan, Zealand, and Zeria pharmaceuticals; has received research grant or support from Abide Therapeutics, Shire, and Zeria; and has served on the speaker bureau for Abbott, Allergan, AstraZeneca, Janssen, Kiowa Kirin, Menarini, Mylan, Novartis, Shire, Takeda, and Zeria. Magnus Simrén has received unrestricted research grants from Danone and Ferring Pharmaceuticals; served as a consultant/advisory board member for AstraZeneca, Danone, Nestlé, Menarini, Almirall, Allergan, Albireo, Glycom, and Shire; and as a speaker for Tillotts, Takeda, Menarini, Allergan Shire, and Almirall. The remaining authors disclose no conflicts.
Publisher Copyright:
© 2018 AGA Institute
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Background & Aims: The Rome IV criteria define functional gastrointestinal (GI) disorders by specific combinations of symptoms. It is possible to empirically evaluate these symptom combinations by factor analysis (a statistical procedure that groups variables that correlate). However, this analysis has not been performed for the Rome IV criteria, and factor analyses based on the previous versions of the Rome criteria did not use population-based data. We therefore investigated symptom grouping by the Rome IV questionnaire using factor analysis of a population-based sample. Methods: The Rome IV questionnaire was completed online in English by 5931 respondents from the United Kingdom, United States, and Canada (49% female, age range, 18–92 years). We performed an exploratory factor analysis on the Rome IV questions. Next, we performed a confirmatory factor analysis to compare the exploratory factor result to that of the Rome IV criteria. Results: The exploratory factor analysis identified 8 factors that accounted for 45% of the variance in response: constipation, diarrhea, irritable bowel syndrome, abdominal pain, heartburn, nausea or vomiting, globus, and other upper GI symptoms. Most factors corresponded to distinct functional GI disorders defined by the Rome IV criteria—exceptions included abdominal pain and upper GI symptoms. In confirmatory factor analysis, the exploratory model fitted slightly better than that based on the Rome IV criteria (root mean square error of approximation, 0.063 vs 0.077). Conclusions: We used factor analysis to identify distinct upper and lower GI symptom groups that are compatible with the Rome IV criteria. Our findings support the use of the Rome IV criteria in research and clinical practice as a basis for development of diagnostics and management of patients.
AB - Background & Aims: The Rome IV criteria define functional gastrointestinal (GI) disorders by specific combinations of symptoms. It is possible to empirically evaluate these symptom combinations by factor analysis (a statistical procedure that groups variables that correlate). However, this analysis has not been performed for the Rome IV criteria, and factor analyses based on the previous versions of the Rome criteria did not use population-based data. We therefore investigated symptom grouping by the Rome IV questionnaire using factor analysis of a population-based sample. Methods: The Rome IV questionnaire was completed online in English by 5931 respondents from the United Kingdom, United States, and Canada (49% female, age range, 18–92 years). We performed an exploratory factor analysis on the Rome IV questions. Next, we performed a confirmatory factor analysis to compare the exploratory factor result to that of the Rome IV criteria. Results: The exploratory factor analysis identified 8 factors that accounted for 45% of the variance in response: constipation, diarrhea, irritable bowel syndrome, abdominal pain, heartburn, nausea or vomiting, globus, and other upper GI symptoms. Most factors corresponded to distinct functional GI disorders defined by the Rome IV criteria—exceptions included abdominal pain and upper GI symptoms. In confirmatory factor analysis, the exploratory model fitted slightly better than that based on the Rome IV criteria (root mean square error of approximation, 0.063 vs 0.077). Conclusions: We used factor analysis to identify distinct upper and lower GI symptom groups that are compatible with the Rome IV criteria. Our findings support the use of the Rome IV criteria in research and clinical practice as a basis for development of diagnostics and management of patients.
KW - FGID
KW - IBS
KW - Internet survey
KW - validation
UR - http://www.scopus.com/inward/record.url?scp=85049047950&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2018.02.042
DO - 10.1016/j.cgh.2018.02.042
M3 - Article
AN - SCOPUS:85049047950
VL - 16
SP - 1252-1259.e5
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
SN - 1542-3565
IS - 8
ER -