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Diagnosis
Review: alarm features in dyspepsia do not have high diagnostic accuracy for predicting upper gastrointestinal cancer

http://dx.doi.org/10.1136/ebm.12.2.55

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    Vakil N, Moayyedi P, Fennerty MB, et al. Limited value of alarm features in the diagnosis of upper gastrointestinal malignancy: systematic review and meta-analysis. Gastroenterology 2006;131:390–401.
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 Q In patients with dyspepsia, what is the accuracy of alarm features (eg, dysphagia, weight loss, or anaemia) for detecting upper gastrointestinal (GI) cancer?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Gastroenterology ★★★★★★☆

    METHODS

    Embedded ImageData sources:

    Medline (1966–2003), CINAHL (1982 to Jan 2005), EMBASE/Excerpta Medica (1988 to Jan 2005), and Cochrane Controlled Trials Register (Jan 2005).

    Embedded ImageStudy selection and assessment:

    prospective studies that evaluated dyspepsia and alarm symptoms in unselected adults (>16 y of age), included >100 patients, compared symptoms with endoscopic diagnosis, and diagnosed >1 upper GI cancer. Studies were pooled using a random effects model. Study quality was assessed. 18 studies met the selection criteria.

    Embedded ImageOutcomes:

    sensitivity, specificity, and likelihood ratios.

    MAIN RESULTS

    Pooled estimates showed that clinical …

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    Footnotes

    • For correspondence: Dr N Vakil, University of Wisconsin Medical School, Milwaukee, WI, USA. nvakil{at}wisc.edu

    • Source of funding: not stated.