title: [Prospective validation of a clinical scoring system for the diagnosis of organic dyspepsia].
abstract: OBJECTIVE
  Predictive symptomatic scoring models have been proposed to select patients with dyspepsia, who may be candidates to endoscopy. In a previous study performed by gastroentrologists from our group, we obtained three scales of symptoms to predict organic dyspepsia, peptic ulcer and esophagitis, respectively. Here we analyze the reproducibility of those scoring models of symptoms when used either by other gastroenterologists or general practitioners.
  
  
  METHODS
  It was a clinical prospective study of 230 patients from the Viladecans hospital area (120 from primary healthcare and 110 from the gastroenterologist's consultation). The three validation scales were performed in each patient. Then, we performed a diagnostic gastroscopy which allowed to classify patients into those with organic dyspepsia (ulcer, esophagitis, cancer) or those with functional dyspepsia. We calculated the overall predictive accuracy for the gastroenterologist and the general practitioner and for the three diagnoses (organic dyspepsia, ulcer or esophagitis) using the C statistic.
  
  
  RESULTS
  Discriminative capacities were 0.75 and 0.82 for organic dyspepsia, 0.78 and 0.86 for ulcer disease, and 0.78 and 0.82 for esophagitis, for the general practitioner and the gastroenterologist, respectively. In this validation study, the best cut-off value, namely the one combining good sensitivity and specificity, was found to be 7.
  
  
  CONCLUSIONS
  A correct predictive capacity of the symptomatic score models when used by other gastroenterologists or by primary healthcare practioners confirms its reproducibility and transferability. The use of predictive symptomatic score models in everyday clinical practice can allow to rationalize the referral for endoscopy in our local setting.
authors.affiliation: Unitat de Digestiu. Hospital de Viladecans. Viladecans. Barcelona. Spain. mbarenys@hv.scs.es
authors.forename: Mercè
authors.initials: M
authors.lastname: Barenys
authors.forename: Rosa
authors.initials: R
authors.lastname: Rota
authors.forename: Víctor
authors.initials: V
authors.lastname: Moreno
authors.forename: Rosa
authors.initials: R
authors.lastname: Villafafila
authors.forename: Inmaculada
authors.initials: I
authors.lastname: García-Bayo
authors.forename: Agueda
authors.initials: A
authors.lastname: Abad
authors.forename: Joan M V
authors.initials: JM
authors.lastname: Pons
authors.forename: Josep M
authors.initials: JM
authors.lastname: Piqué
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D004415:Dyspepsia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results