Pattern and validity of clinical diagnosis of upper gastrointestinal diseases in south-west Nigeria.
BACKGROUND
Diagnosis of upper gastrointestinal (UGI) diseases is often made on clinical grounds alone in Nigeria due to lack of endoscopic facilities. The validity of using such diagnosis is presently unknown.


OBJECTIVE
The study aimed to determine: age and sex distribution of patients presenting for UGI endoscopy; pattern of clinical and endoscopic diagnoses in patients with UGI diseases; and, the validity of clinic-based diagnosis.


METHODS
Medical records of patients presenting at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria for UGI endoscopy between September 1999 and August 2003 were reviewed. Data was analysed for sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis using endoscopic diagnosis as "gold" standard.


RESULTS
Males constituted 53.4% of subjects and mean age was 45 years (+/- 1.69 SD). Peptic ulcer disease (PUD) constituted 67.6% of referral diagnosis but 33.9% of endoscopic diagnosis. PUD had the highest sensitivity value (0.72) while gastritis had the least (0.04). Specificity ranged from 0.40 for PUD to 1.00 for corrosive oesophagitis. Positive predictive value ranged from 0.29 (oesophageal cancer) to 0.67 (corrosive oesophagitis) and negative predictive value ranged from 0.66 for gastritis to 0.99 for corrosive oesophagitis.


CONCLUSIONS
The validity of clinical diagnosis in UGI conditions varied widely, and in general, there is poor agreement between clinical and endoscopic diagnoses.
Agbakwuru
E A
EA
Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
Fatusi
A O
AO
Ndububa
D A
DA
Alatise
O I
OI
Arigbabu
O A
OA
Akinola
D O
DO
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D055815:Young Adult