DISCRIMINANT VALUE OF SYMPTOMS IN PATIENTS WITH DYSPEPSIA

Background. Family physicians encounter many pitfalls in managing and treating dyspeptic patients, most of whom are treated in family practi ce based solely on their signs and symptoms. Methods. A computer liter ature search followed by a systematic methodological appraisal was per formed to identify studies that evaluated clinical symptomatology in d yspeptic patients. Results. Ten studies, none of which took place in a family practice, fulfilled our inclusion criteria. The main conclusio n drawn from outpatient populations and patients referred for open-acc ess endoscopy was that certain clusters of symptoms have a negative pr edictive value for organic causes of dyspepsia. Higher age, male sex, pain at night, relief by antacids or food, and previous history of pep tic ulcer disease were identified as predictors of organic causes for abdominal symptoms. Conclusions. These findings can be helpful to fami ly physicians in determining the need for endoscopy referral. However, since the diagnostic values of tests in family practice may differ fr om those in referred populations, there is a need for prospective stud ies in primary care.