# Automated Assessment of Pediatric Rome IV Criteria Using Computerized Decision Support

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2020 · $505,843

## Abstract

Functional gastrointestinal disorders (FGIDs) are extremely common in children and adolescents, and
represent a wide range of disorders that are related to the gastrointestinal tract, but have no clear structural,
anatomic, or histopathologic cause. FGIDs represent an enormous burden on patients and families, and
patients with these functional disorders have much higher health care utilization and related costs. As there are
no biochemical markers or structural abnormalities that can be used to diagnose these disorders in children
objectively, FGIDs are diagnosed according to the symptom-based Rome criteria. While gastroenterologists
care for many of the pediatric patients with FGIDs, the majority of the burden continues to be borne by general
pediatricians, especially with respect to initial diagnosis. Unfortunately, FGIDs are often diagnosed incorrectly
by primary care providers, and patients often wait months to years before a correct diagnosis is made, and
effective treatment is begun. Furthermore, primary care providers are often unaware of recent guideline
changes or the evidence base for children with FGIDs, leading to overuse of testing, inappropriate or
ineffective treatment, and increased costs. Given this information, it is essential that we develop interventions
that target pediatric primary care providers to improve their care for children with FGIDs. We propose that
using a Clinical Decision Support System (CDSS) that incorporates the Rome IV criteria for diagnosis and
evidence-based care for FGIDs will improve the (1) accuracy of diagnosis and (2) effectiveness of clinical care.
A CDSS has advantages with respect to guideline adherence and automated diagnosis, because it can provide
focused, real-time, patient-specific data to the clinician. Studies of barriers to guideline implementation have
shown multiple factors at work: unfamiliarity with a guideline, lack of self-efficacy, or difficulty implementing the
guideline components within the current workflow of a practice. CDSS can overcome many of these barriers
because they are integrated with systems that routinely store and retrieve patient information and can improve
workflow by providing clinicians with patient-specific advice at the time of the patient visit. Our research group
at IUSM has previously developed an efficient, robust, highly accurate computerized CDSS for use in the
primary care setting: the Child Health Improvement through Computerized Automation (CHICA) system. We
hypothesize that automation of screening, diagnosis, and management of FGIDs using the Rome IV criteria will
result in improved resolution of FGIDs (primary outcome), as well as decreased utilization of medical services
(secondary outcomes). We propose to test this hypothesis using the following specific aims: (1) Expand and
modify an existing computer-based decision support system (CHICA), to screen children 0 to 18 years of age
for functional gastrointestinal disorders (FGIDs) using the Rome IV cri...

## Key facts

- **NIH application ID:** 9898360
- **Project number:** 5R01DK118433-02
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** William Estus Bennett
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $505,843
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9898360

## Citation

> US National Institutes of Health, RePORTER application 9898360, Automated Assessment of Pediatric Rome IV Criteria Using Computerized Decision Support (5R01DK118433-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9898360. Licensed CC0.

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