Diagnostic Accuracy of Age and Alarm Symptoms for Upper GI Malignancy in Patients with Dyspepsia in a GI Clinic: A 7-Year Cross-Sectional Study
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{"title"=>"Diagnostic accuracy of age and alarm symptoms for upper GI malignancy in patients with dyspepsia in a GI clinic: A 7-year cross-sectional study", "type"=>"journal", "authors"=>[{"first_name"=>"Hooman", "last_name"=>"Khademi", "scopus_author_id"=>"22734120700"}, {"first_name"=>"Amir Reza", "last_name"=>"Radmard", "scopus_author_id"=>"8608575700"}, {"first_name"=>"Fatemeh", "last_name"=>"Malekzadeh", "scopus_author_id"=>"24341778400"}, {"first_name"=>"Farin", "last_name"=>"Kamangar", "scopus_author_id"=>"6603901311"}, {"first_name"=>"Siavosh", "last_name"=>"Nasseri-Moghaddam", "scopus_author_id"=>"6603327102"}, {"first_name"=>"Mattias", "last_name"=>"Johansson", "scopus_author_id"=>"56447900600"}, {"first_name"=>"Graham", "last_name"=>"Byrnes", "scopus_author_id"=>"24390455900"}, {"first_name"=>"Paul", "last_name"=>"Brennan", "scopus_author_id"=>"7402304490"}, {"first_name"=>"Reza", "last_name"=>"Malekzadeh", "scopus_author_id"=>"7005197760"}], "year"=>2012, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"364996215", "doi"=>"10.1371/journal.pone.0039173", "isbn"=>"1932-6203 (Electronic)\r1932-6203 (Linking)", "pmid"=>"22720064", "issn"=>"19326203", "scopus"=>"2-s2.0-84862238104", "sgr"=>"84862238104"}, "id"=>"b8752ef0-b7de-3102-8837-e27a202bdaf7", "abstract"=>"OBJECTIVES: We investigated whether using demographic characteristics and alarm symptoms can accurately predict cancer in patients with dyspepsia in Iran, where upper GI cancers and H. pylori infection are common.\\n\\nMETHODS: All consecutive patients referred to a tertiary gastroenterology clinic in Tehran, Iran, from 2002 to 2009 were invited to participate in this study. Each patient completed a standard questionnaire and underwent upper gastrointestinal endoscopy. Alarm symptoms included in the questionnaire were weight loss, dysphagia, GI bleeding, and persistent vomiting. We used logistic regression models to estimate the diagnostic value of each variable in combination with other ones, and to develop a risk-prediction model.\\n\\nRESULTS: A total of 2,847 patients with dyspepsia participated in this study, of whom 87 (3.1%) had upper GI malignancy. Patients reporting at least one of the alarm symptoms constituted 66.7% of cancer patients compared to 38.9% in patients without cancer (p<0.001). Esophageal or gastric cancers in patients with dyspepsia was associated with older age, being male, and symptoms of weight loss and vomiting. Each single predictor had low sensitivity and specificity. Using a combination of age, alarm symptoms, and smoking, we built a risk-prediction model that distinguished between high-risk and low-risk individuals with an area under the ROC curve of 0.85 and acceptable calibration.\\n\\nCONCLUSIONS: None of the predictors demonstrated high diagnostic accuracy. While our risk-prediction model had reasonable accuracy, some cancer cases would have remained undiagnosed. Therefore, where available, low cost endoscopy may be preferable for dyspeptic older patient or those with history of weight loss.", "link"=>"http://www.mendeley.com/research/diagnostic-accuracy-age-alarm-symptoms-upper-gi-malignancy-patients-dyspepsia-gi-clinic-7year-crosss", "reader_count"=>15, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Student > Postgraduate"=>3, "Student > Master"=>4, "Student > Bachelor"=>3, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Student > Postgraduate"=>3, "Student > Master"=>4, "Student > Bachelor"=>3, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>4, "Medicine and Dentistry"=>9, "Agricultural and Biological Sciences"=>2}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>9}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Unspecified"=>{"Unspecified"=>4}}, "group_count"=>0}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/324171", "https://ndownloader.figshare.com/files/324227"], "description"=>"<div><h3>Objectives</h3><p>We investigated whether using demographic characteristics and alarm symptoms can accurately predict cancer in patients with dyspepsia in Iran, where upper GI cancers and <em>H. pylori</em> infection are common.</p> <h3>Methods</h3><p>All consecutive patients referred to a tertiary gastroenterology clinic in Tehran, Iran, from 2002 to 2009 were invited to participate in this study. Each patient completed a standard questionnaire and underwent upper gastrointestinal endoscopy. Alarm symptoms included in the questionnaire were weight loss, dysphagia, GI bleeding, and persistent vomiting. We used logistic regression models to estimate the diagnostic value of each variable in combination with other ones, and to develop a risk-prediction model.</p> <h3>Results</h3><p>A total of 2,847 patients with dyspepsia participated in this study, of whom 87 (3.1%) had upper GI malignancy. Patients reporting at least one of the alarm symptoms constituted 66.7% of cancer patients compared to 38.9% in patients without cancer (p<0.001). Esophageal or gastric cancers in patients with dyspepsia was associated with older age, being male, and symptoms of weight loss and vomiting. Each single predictor had low sensitivity and specificity. Using a combination of age, alarm symptoms, and smoking, we built a risk-prediction model that distinguished between high-risk and low-risk individuals with an area under the ROC curve of 0.85 and acceptable calibration.</p> <h3>Conclusions</h3><p>None of the predictors demonstrated high diagnostic accuracy. While our risk-prediction model had reasonable accuracy, some cancer cases would have remained undiagnosed. Therefore, where available, low cost endoscopy may be preferable for dyspeptic older patient or those with history of weight loss.</p> </div>", "links"=>[], "tags"=>["diagnostic", "symptoms", "gi", "malignancy", "patients", "dyspepsia", "7-year", "cross-sectional"], "article_id"=>123968, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0039173.s001", "https://dx.doi.org/10.1371/journal.pone.0039173.s002"], "stats"=>{"downloads"=>16, "page_views"=>18, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Diagnostic_Accuracy_of_Age_and_Alarm_Symptoms_for_Upper_GI_Malignancy_in_Patients_with_Dyspepsia_in_a_GI_Clinic_A_7_Year_Cross_Sectional_Study/123968", "title"=>"Diagnostic Accuracy of Age and Alarm Symptoms for Upper GI Malignancy in Patients with Dyspepsia in a GI Clinic: A 7-Year Cross-Sectional Study", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-06-13 01:06:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/624826"], "description"=>"<p>Risk-prediction model for predicting risk of upper GI malignancy in dyspeptic patients.</p>", "links"=>[], "tags"=>["predicting", "gi", "malignancy", "dyspeptic"], "article_id"=>295300, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t004", "stats"=>{"downloads"=>0, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_prediction_model_for_predicting_risk_of_upper_GI_malignancy_in_dyspeptic_patients_/295300", "title"=>"Risk-prediction model for predicting risk of upper GI malignancy in dyspeptic patients.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:28:20"}
  • {"files"=>["https://ndownloader.figshare.com/files/624884"], "description"=>"*<p>Model2: age plus four alarm symptoms (weigh loss, persistent vomiting, GI bleeding, dysphagia); Model3: risk-prediction model.</p>", "links"=>[], "tags"=>["risk-prediction"], "article_id"=>295367, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t007", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Reclassification_table_for_age_and_alarm_symptom_model_Model2_and_risk_prediction_model_Model3_/295367", "title"=>"Reclassification table for age and alarm symptom model (Model2) and risk-prediction model (Model3).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:29:27"}
  • {"files"=>["https://ndownloader.figshare.com/files/625081"], "description"=>"<p>Endoscopic and histologic findings in study population.</p>", "links"=>[], "tags"=>["histologic", "findings"], "article_id"=>295563, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t002", "stats"=>{"downloads"=>1, "page_views"=>19, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Endoscopic_and_histologic_findings_in_study_population_/295563", "title"=>"Endoscopic and histologic findings in study population.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:32:43"}
  • {"files"=>["https://ndownloader.figshare.com/files/624930"], "description"=>"*<p>Model1: age only; Model2: age plus four alarm symptoms (weigh loss, persistent vomiting, GI bleeding, dysphagia); Model3: risk-prediction model.</p>**<p>Brier<i><sub>scaled</sub></i> = 1−Brier/Brier<i><sub>max</sub></i>, where Brier<i><sub>max</sub></i> = mean(p)<i>×</i>(1−mean(p)); and mean(p) is mean probability of outcome prediction based on model.</p>", "links"=>[], "tags"=>["models", "predicting", "ugi", "malignancy", "dyspeptic"], "article_id"=>295406, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t006", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Performance_of_three_different_models_for_predicting_UGI_malignancy_in_dyspeptic_patients_/295406", "title"=>"Performance of three different models for predicting UGI malignancy in dyspeptic patients.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:30:06"}
  • {"files"=>["https://ndownloader.figshare.com/files/624774"], "description"=>"£<p>The number of patients that have a RS of less than the chosen threshold.</p>€<p>The number of cancer patients that have a RS of less than the chosen threshold and consequently are missed, due to not being selected for prompt endoscopy.</p>¥<p>The probability of having cancer when the RS is exactly equal to the threshold, according to mentioned formulae in the method section.</p>", "links"=>[], "tags"=>["diagnostic", "characteristics", "choosing", "cut-off", "derived", "risk-prediction"], "article_id"=>295251, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t005", "stats"=>{"downloads"=>0, "page_views"=>0, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_diagnostic_characteristics_of_choosing_different_risk_score_cut_off_levels_derived_from_the_risk_prediction_model_/295251", "title"=>"The diagnostic characteristics of choosing different risk score cut-off levels, derived from the risk-prediction model.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:27:31"}
  • {"files"=>["https://ndownloader.figshare.com/files/624980"], "description"=>"€<p>Since we had some missing information in educational level, weigh, height, and <i>H. pylori</i> test results, the sum of frequencies in these variables is not equal to study sample size.</p>‡<p><i>H. pylori</i> infection was detected based on Rapid Urease Test (RUT), during endoscopy.</p>*<p><i>P</i> values are calculated using independent sample t-test for age and chi-square tests for other variables to compare the distribution of the variables between patients with and without UGI malignancy.</p>", "links"=>[], "tags"=>["habits", "symptoms", "dyspeptic", "patients", "gi"], "article_id"=>295460, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t001", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Demographic_characteristics_habits_and_distribution_of_alarm_symptoms_in_all_dyspeptic_patients_and_who_with_upper_GI_malignancy_/295460", "title"=>"Demographic characteristics, habits and distribution of alarm symptoms in all dyspeptic patients and who with upper GI malignancy.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:31:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/624656"], "description"=>"<p>ROC curves based on three predictive model for upper GI malignancy in dyspeptic patients, including model1; only age included, model2; age plus alarm symptoms, and model3; the risk-prediction model.</p>", "links"=>[], "tags"=>["curves", "predictive", "gi", "malignancy", "dyspeptic", "risk-prediction"], "article_id"=>295130, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.g002", "stats"=>{"downloads"=>1, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_ROC_curves_based_on_three_predictive_model_for_upper_GI_malignancy_in_dyspeptic_patients_including_model1_only_age_included_model2_age_plus_alarm_symptoms_and_model3_the_risk_prediction_model_/295130", "title"=>"ROC curves based on three predictive model for upper GI malignancy in dyspeptic patients, including model1; only age included, model2; age plus alarm symptoms, and model3; the risk-prediction model.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-06-13 01:25:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/625042"], "description"=>"€<p>Multivariable model is adjusted for age, gender, educational level, cigarette smoking and history of weight loss, GI bleeding, persistent vomiting and dysphagia.</p>‡<p><i>H. pylori</i> infection is detected based on Rapid Urease Test (RUT), during endoscopy.</p>", "links"=>[], "tags"=>["ratios", "characteristics", "symptoms", "gi", "unadjusted", "multivariable", "adjusted", "regression"], "article_id"=>295515, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.t003", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Estimated_odds_ratios_of_demographic_characteristics_and_alarm_symptoms_for_upper_GI_malignancies_based_on_unadjusted_and_multivariable_adjusted_regression_models_/295515", "title"=>"Estimated odds ratios of demographic characteristics and alarm symptoms for upper GI malignancies, based on unadjusted and multivariable adjusted regression models.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-06-13 01:31:55"}
  • {"files"=>["https://ndownloader.figshare.com/files/624566"], "description"=>"<p>The risk scores and their corresponding risk probabilities derived from the suggested risk-prediction model.</p>", "links"=>[], "tags"=>["scores", "corresponding", "probabilities", "derived", "suggested", "risk-prediction"], "article_id"=>295034, "categories"=>["Cancer", "Chemistry"], "users"=>["Hooman Khademi", "Amir-Reza Radmard", "Fatemeh Malekzadeh", "Farin Kamangar", "Siavosh Nasseri-Moghaddam", "Mattias Johansson", "Graham Byrnes", "Paul Brennan", "Reza Malekzadeh"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0039173.g001", "stats"=>{"downloads"=>0, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_The_risk_scores_and_their_corresponding_risk_probabilities_derived_from_the_suggested_risk_prediction_model_/295034", "title"=>"The risk scores and their corresponding risk probabilities derived from the suggested risk-prediction model.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-06-13 01:23:54"}

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Relative Metric

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