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The Rational Clinical Examination
David L. Simel, Drummond Rennie
Dyspepsia
David L. Simel
Endoscopy is the accepted reference standard test for the patient with dyspepsia as it has both a...


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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