We have located links that may give you full text access.
Non-acute abdominal complaints in general practice: diagnostic value of signs and symptoms.
British Journal of General Practice 1995 June
BACKGROUND: Although many patients are evaluated initially by their general practitioner, clinicians' accuracy at diagnosing organic gastrointestinal disease has not been studied in a primary care setting. Different spectra of severity of disease in general practice and hospital populations may lead to different values for diagnostic tests in these two populations.
AIM: This study set out to determine the diagnostic value of history and physical and laboratory items for organic and neoplastic disease in general practice patients with nonacute abdominal complaints.
METHOD: The one-year prospective, observational study was carried out in 1989 in 80 general practices in Limburg, the Netherlands. The study subjects were 933 patients (aged 18-75 years) presenting to their general practitioner with new non-acute abdominal complaints of minimum duration two weeks, and with whom the doctor had a diagnostic problem. Patients were physically examined by their general practitioner and asked to complete pre-structured questionnaires. Basic laboratory tests were carried out. Patients were followed up for at least one year by researchers and then a diagnosis was determined by an independent panel of three general practitioners using patient records, blinded for the results of the questionnaires. Sensitivity, specificity and odds ratios were calculated for clinical items. Stepwise forward logistic regression analysis was undertaken to identify independent predictors of organic gastrointestinal disease.
RESULTS: Of the 933 patients 14% had organic gastrointestinal disease. No clinical item had both high sensitivity and specificity. Logistic regression analysis showed only eight independent predictors of organic disease: male sex, greater age, epigastric pain, no specific character to pain, pain affecting sleep, history of blood in stool, no pain relief after defecation and abnormal white blood cell count. When the model was programmed to predict neoplasms five items were found: male sex, greater age, no specific character to pain, weight loss and erythrocyte sedimentation rate greater than 20 mm hour-1.
CONCLUSION: In a general practice population with non-acute abdominal complaints some clinical findings can be used as predictors for organic and neoplastic gastrointestinal disease.
AIM: This study set out to determine the diagnostic value of history and physical and laboratory items for organic and neoplastic disease in general practice patients with nonacute abdominal complaints.
METHOD: The one-year prospective, observational study was carried out in 1989 in 80 general practices in Limburg, the Netherlands. The study subjects were 933 patients (aged 18-75 years) presenting to their general practitioner with new non-acute abdominal complaints of minimum duration two weeks, and with whom the doctor had a diagnostic problem. Patients were physically examined by their general practitioner and asked to complete pre-structured questionnaires. Basic laboratory tests were carried out. Patients were followed up for at least one year by researchers and then a diagnosis was determined by an independent panel of three general practitioners using patient records, blinded for the results of the questionnaires. Sensitivity, specificity and odds ratios were calculated for clinical items. Stepwise forward logistic regression analysis was undertaken to identify independent predictors of organic gastrointestinal disease.
RESULTS: Of the 933 patients 14% had organic gastrointestinal disease. No clinical item had both high sensitivity and specificity. Logistic regression analysis showed only eight independent predictors of organic disease: male sex, greater age, epigastric pain, no specific character to pain, pain affecting sleep, history of blood in stool, no pain relief after defecation and abnormal white blood cell count. When the model was programmed to predict neoplasms five items were found: male sex, greater age, no specific character to pain, weight loss and erythrocyte sedimentation rate greater than 20 mm hour-1.
CONCLUSION: In a general practice population with non-acute abdominal complaints some clinical findings can be used as predictors for organic and neoplastic gastrointestinal disease.
Full text links
Related Resources
Trending Papers
Heart failure with preserved ejection fraction: diagnosis, risk assessment, and treatment.Clinical Research in Cardiology : Official Journal of the German Cardiac Society 2024 April 12
Proximal versus distal diuretics in congestive heart failure.Nephrology, Dialysis, Transplantation 2024 Februrary 30
Efficacy and safety of pharmacotherapy in chronic insomnia: A review of clinical guidelines and case reports.Mental Health Clinician 2023 October
World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.American Journal of Hematology 2024 March 30
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app