A Test of a Linear Discriminant for Identifying Low-Risk Abdominal Pain

Abstract

This study tests a previously published decision rule for identifying nonspecific abdominal pain (NSAP). The rule, developed for ambulatory male patients in two Veterans Administration (VA) facilities and a prepaid group practice, was studied in an additional 110 VA patients and in 77 patients (predominantly female) from a solo private practice. The group of 58 patients (33%) classified as "low-risk" rarely had abnormal laboratory tests or radiographs, except for upper gastrointestinal series; 15 of these patients had potentially serious disease. Peptic ulcer was the specific diagnosis most often misclassified as NSAP. The accuracy of the rule in our population is similar to the accuracy of the judgment of experienced clinicians.

Systematic review: accuracy of symptom‐based criteria for diagnosis of irritable bowel syndrome in primary care

“…The literature search yielded 858 references. A total of 89 full papers were retrieved, of which 26 were finally considered relevant for the review 7, 22–46 . Reference checking yielded two additional relevant papers 47, 48 .…”

“…Reference checking yielded two additional relevant papers 47, 48 . With results of two studies being published in a total of five papers, 35, 36, 40–42 a total of 25 primary diagnostic studies were included in the review. A summary of the search results is presented in Figure 1.…”

Computer-Aided Diagnosis and Decision-Making in Acute Abdominal Pain

“…The Achilles heel of the method was the rec ognition of peptic ulcer disease since these cases were classed as NSAP. This diagnostic system was tested in another trial with basi cally identical results [43], Table 2 illustrates four possible groups of patients with acute abdominal pain with re spect to the quality of diagnosis and deci sion-making: in group A we find the ideally treated cases with correct diagnosis and deci sion-making: group B patients were correctly diagnosed but because of wrong decision were not given timely optimal treatment: in group C the diagnosis was not correct but since the decision-making was correct the patient outcome was probably acceptable, finally, in group D we find patients misdiag nosed and incorrectly treated because of bad decision-making, which resulted in poor pa tient outcome.…”