Dutta et al reported a simple score for predicting malignancy in a patient with dyspepsia. This can help to identify a patient who should have endoscopy. The authors from Christian Medical College in Vellore, Madurai Kamaraj University, IMS and SUM Hospital, Yashoda Hospital and The Madras Medical Mission in India.
Patient selection: dyspepsia
Parameters:
(1) recent onset of symptoms (<= 6 months)
(2) alarm symptoms (anorexia, weight loss, dysphagia, vomiting, upper GI bleed, palpable abdominal mass).
(3) age in years
(4) hemoglobin in g/dL
(5) serum albumin in g/dL
|
Parameter
|
Finding
|
Points
|
|
recent symptom onset
|
no
|
0
|
|
|
yes
|
3
|
|
alarm symptoms
|
no
|
0
|
|
|
yes
|
2
|
|
age in years
|
<= 40 years
|
0
|
|
|
> 40 years
|
1
|
|
hemoglobin
|
<= 11 g/dL
|
1
|
|
|
> 11 g/dL
|
0
|
|
serum albumin
|
<= 3.5 g/dL
|
1
|
|
|
> 3.5 g/dL
|
0
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score >= 2 is an indication for upper GI endoscopy.
• The higher the score the greater the risk of esophageal cancer.
Performance:
• The area under the ROC curve is 0.90.
• A score >= 2 has a sensitivity of 0.925 and specificity of 0.675.
• A score >= 3 has a sensitivity of 0.819 and specificity of 0.831.
