THE DIAGNOSTIC-VALUE OF SCORING MODELS FOR ORGANIC AND NONORGANIC GASTROINTESTINAL-DISEASE, INCLUDING THE IRRITABLE-BOWEL-SYNDROME

Scoring models based on history and physical examination have been dev eloped to discriminate patients with non-organic gastrointestinal dise ase from those who have organic disease. The application of these mode ls may lead to more efficient diagnosis and prevent somatization. Alth ough the models have high diagnostic accuracy in the population in whi ch they have been developed, their value in other populations has not been established. In this study previously developed models were teste d in validation populations defined by the original selection criteria from the studies in which the models were developed and in unselected general practice and outpatient populations. The diagnostic performan ces of the models are expressed in terms of odds ratio and sensitivity and specificity for the classification of patients as having organic and non-organic disease. The diagnostic performances of all the models were rather low in the validation populations. Relatively few element s of the models had independent diagnostic value. In addition, the cor relation between the scoring models, expressed in Cohen's kappa, was e xtremely low. The diagnostic values of the scoring models were not rep roduced in comparable and unselected populations. Therefore, it is con cluded that the diagnostic value of such a model has little external v alidity.