STUDY OF VISCERAL SENSITIVITY MEASURED BY RECTAL BAROSTAT IN PEDIATRIC PATIENTS SUFFERING FROM FUNCTIONAL GASTROINTESTINAL DISORDERS.
Bibliographic record
Abstract
Functional gastrointestinal disorders (FGD) are a frequent problem in the pediatric population. 70% of adults with irritable bowel syndrome (IBS) present low visceral sensitivity thresholds. Recent literature seems to confirm this notion in children with FGD. However, the diagnostic value of the determination of the visceral sensitivity threshold remains unknown. Aims: 1-to measure the rectal sensory threshold (RST) in IBS, functional abdominal pain (FAP) and functional dyspepsia (FD) pediatric patients and to compare it with control children, 2-to evaluate the projections of the sensations induced by the rectal distension and 3-to evaluate the diagnostic value of the rectal sensory threshold measurement. Methods: 35 patients (10 to 17 y) with IBS (n = 21), FAP (n = 8) and FD (n = 6) (according to Rome II criteria) underwent a series of rectal isobaric balloon distensions (from 2 mmHg to a maximum of 48 mmHg with tracking) using an electronic barostat (G&J, Toronto, ON). The patients' perception (gas, stool, discomfort, pain) was noted during each distension. RST was defined as the pressure in the balloon when abdominal pain was experienced. Children were also asked to draw on a standardized human body diagram their pain experienced at home and during the procedure. Controls: 6 children were recruited in the patients' siblings. Results: RST was lower in IBS (P < 0.002) and FAP (P < 0.012) than in control children. 85% (95%CI [69-100]) of IBS patients and 87% (95%CI [58-100]) of FAP patients had a RST = 30 mmHg, the 25th percentile of control children. The localization of the pain experienced during the procedure correlated with pain experienced at home in 90% of the IBS patients, 87% of the FAP patients, and only 20% of the FD patients. At 30 mmHg, the rectal sensory threshold measurement for diagnosis of IBS and FAP had a sensitivity = 89% (95%CI [77-100]), a specificity = 83% (95%CI [40-100]), a positive predictive value = 96% (95%CI [88-100]) and a negative predictive value = 55% (95%CI [15-96]). Conclusion: The barostat study can be safely used in children. A RST <30 mmHg associated with an induction of the patients' typical symptoms is highly suggestive of IBS or FAP. The barostat provides a positive biologic criterion that, in addition to the positive clinical criteria (Rome II), may be useful to confirm the clinical diagnosis of functional gastrointestinal disorder.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".