The Rational Clinical Examination
David L. Simel, Drummond Rennie
Dyspepsia
David L. Simel
Make the Diagnosis: Does This Patient With Epigastric Discomfort Have Organic or Functional Dyspepsia?
Topics Discussed:
barrett's esophagus, computer simulation, criterion standard comparisons (diagnostic tests), diagnosis, dyspepsia, endoscopy, epigastric pain, esophagitis, gastroesophageal reflux disease, likelihood ratio, make the diagnosis, peptic ulcer, prior probability
Excerpt:
"About 40% of adults experience some sort of upper gastrointestinal
symptoms during any 6-month period, but only about half of these
patients tell their physicians about the symptoms.1 Clinicians
use clinical judgment and/or response to empirical treatment
to make the majority of their diagnoses in patients with dyspepsia.
Among those who seek care for their symptoms, only about 5% are
referred to gastroenterologists where the prevalence of underlying
conditions can be determined (Table 69-1).2..."
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