Rome III Versus Rome IV Criteria for Diagnosing Irritable Bowel Syndrome in a Southeast Asian Population: Insights From the Rome Foundation Global Epidemiology Study Household Survey
Bibliographic record
Abstract
INTRODUCTION: Previous Asian studies have reported a substantial decline in irritable bowel syndrome (IBS) prevalence following the adoption of the Rome IV diagnostic criteria. However, comparative data on IBS prevalence using Rome III and Rome IV criteria remain sparse, especially in Southeast Asia. METHODS: We analyzed household survey data from the Rome Foundation Global Epidemiology Study conducted in Malaysia and Indonesia, the only Southeast Asian countries included in the study, utilizing household-based sampling. We compared diagnostic sensitivity between Rome III and Rome IV criteria for IBS and examined demographic characteristics, symptom severity, psychological distress, quality of life (QoL), healthcare utilization, and dietary habits among identified IBS participants. RESULT: Of 3411 participants (Malaysia: 2072; Indonesia: 1339), 177 (5.2%) fulfilled IBS criteria according to either Rome III or IV criteria. Among these, 115 (65%) met only the Rome III criteria, 50 (28%) met both the Rome III and IV criteria, and 12 (7%) exclusively met the Rome IV criteria. Compared with those diagnosed by Rome III, individuals identified by Rome IV criteria were younger and predominantly female. Only 31% of the Rome III IBS cases remained classified as IBS under the Rome IV criteria, while others were reclassified as unspecified bowel disorder (24%) or functional constipation (17%). While healthcare utilization rates were similar across groups, Rome IV IBS participants exhibited significantly higher symptom severity, lower anxiety levels, and poorer mental health-related QoL. Dietary assessments revealed significantly lower intake of milk, meat products, fish, eggs, vegetables and legumes, fruit, bread, and pasta among Rome IV IBS participants. CONCLUSION: The Rome IV criteria for IBS demonstrate reduced diagnostic sensitivity compared with the Rome III criteria in the Southeast Asian populations. Individuals meeting the Rome IV criteria displayed distinct demographic and clinical characteristics, including greater symptom severity and reduced mental health-related QoL.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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".