P. Bytzer et al., PREDICTING ENDOSCOPIC DIAGNOSIS IN THE DYSPEPTIC PATIENT - THE VALUE OF PREDICTIVE SCORE MODELS, Scandinavian journal of gastroenterology, 32(2), 1997, pp. 118-125
Background: Score models to predict endoscopic diagnosis in dyspepsia
may compensate for the unreliable clinical diagnosis. This study aimed
to construct and test score models designed to predict diagnosis in d
yspepstic patients managed in primary care. Methods: Three models to p
redict organic dyspepsia, major dyspepsia or peptic ulcer were constru
cted by regression analysis of clinical data from 1026 consecutive dys
peptic patients referred for endoscopy. The models were tested in 207
patients in primary care, who were potential candidates for endoscopy.
Validation experiments were analysed using receiver operating charact
eristic (ROC) curves. Results: Significant losses of predictive power
were found for all models when applied to primary care patients, and n
o model could be used as a reliable decision support instrument in pri
mary care. Conclusions: Predictive score models developed in patients
referred for endoscopy are not reliable when applied to patients in pr
imary care who are potential candidates for endoscopy. Future models s
hould be constructed and validated in unselected primary care populati
ons.