An interactive online clinical decision toolkit that combines the Rome IV criteria for diagnosis and classification of functional gastrointestinal (GI) disorders with multidimensional clinical profile (MDCP) treatment guidelines was on display at United European Gastroenterology (UEG) Week 2016 in Vienna.
"We are going beyond the textbooks to help clinicians make decisions about diagnosis and treatment, even in primary care," said Douglas Drossman, MD, professor emeritus at University of North Carolina Center for Functional GI and Motility Disorders in Chapel Hill, who is president of the Rome Foundation.
"The software system incorporates the algorithm book and the MDCP book into an online toolkit, into which clinicians can put information and get recommendations about diagnosis and treatment. That's the highlight," Dr Drossman told Medscape Medical News.
The Rome IV criteria, launched earlier this year, replaced the Rome III criteria, which were published in 2006.
The update was sorely needed, said Dr Drossman. In the past 10 years, there has been "unprecedented progress" in our understanding of functional GI disorders, and there are now better treatments available for these patients, he explained in a news release.
One of the major changes in the updated criteria is the redefinition of functional GI disorders; they are now considered "disorders of the gut–brain interaction." Another change is the removal of the term "functional" when it is not needed.
There have also been threshold changes to improve the clinical meaningfulness of diagnostic criteria, including a revision of criteria for sphincter of Oddi dysfunction and a reconceptualization of irritable bowel syndrome and its subtypes, with the term "discomfort" removed from its diagnostic criteria.
"We want to help clinicians in Europe and around the world understand the new criteria, integrate them into their own diagnostic workups, and optimize their patient management," Dr Drossman said.
Rome III set the standard for the selection of patients for clinical trials, and the US Food and Drug Administration requires those criteria to be met for treatment trials. "So there has been an acceptance of this in the academic and the clinical trial arenas, but it hasn't reached the clinicians," Dr Drossman told Medscape Medical News.
He has been traveling the globe to raise awareness of Rome IV. "In the last 3 months, I was in Korea, Brazil, Cartagena, London, and now Vienna, and after that, I go to China and Mexico, and then Japan in March," he said. "Every country wants to know what is new for Rome IV."
The educational materials available from the Rome Foundation include a two-volume Rome IV textbook, as well as supplementary clinically oriented books that contain diagnostic algorithms, multimodal treatments that adhere to MDCP guidelines, and books targeted to pediatrics and primary care.
In this way, the clinician can find the book that is best suited to their specific interests, said Dr Drossman. And the online toolkit, which is expected to become available in the next several months, will enhance the value of the books by guiding clinicians through the complex challenges of working with patients with functional GI disorders.
"We are trying to meet the needs of clinicians by drilling down from the textbook information to case-based methods of making a diagnosis with algorithms, and then to treatment using a multidimensional framework that also looks at quality of life, the severity of illness, and psychological issues," he explained.
Dr Drossman has disclosed no relevant financial relationships.
United European Gastroenterology (UEG) Week. Presented October 17, 2016.
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Cite this: New Interactive Online Toolkit Features Rome IV Criteria - Medscape - Oct 18, 2016.