Orient J M, Kettel L J, Lim J
Med Decis Making. 1985;5(1):77-87. doi: 10.1177/0272989X8500500116.
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.
本研究对先前发表的一项用于识别非特异性腹痛(NSAP)的决策规则进行了测试。该规则是针对两家退伍军人管理局(VA)医疗机构和一家预付团体医疗诊所的门诊男性患者制定的,此次在另外110名VA患者以及来自一家个体私人诊所的77名患者(主要为女性)中进行了研究。被归类为“低风险”的58名患者(33%)除上消化道造影外,很少有实验室检查异常或X光片异常;这些患者中有15人患有潜在的严重疾病。消化性溃疡是最常被误诊为NSAP的具体诊断。该规则在我们研究人群中的准确性与经验丰富的临床医生判断的准确性相似。