A Simple Pre-endoscopy Score for Predicting Risk of Malignancy in Patients with Dyspepsia: A 5-Year Prospective Study

Area of Science:

• Gastroenterology
• Oncology
• Clinical Diagnostics

Background:

• Current guidelines for endoscopy in dyspeptic patients rely on clinical parameters with variable accuracy.
• There is a need for improved predictive tools to identify patients at high risk for upper gastrointestinal malignancy (UGIM).

Purpose of the Study:

• To prospectively develop and validate a scoring model using clinical and laboratory data.
• The model aims to identify dyspeptic patients with a high risk of UGIM.

Main Methods:

• Prospective recruitment of adult dyspeptic patients over 5 years.
• Collected clinical data, alarm features, hemoglobin, and albumin levels before endoscopy.
• Developed a predictive scoring model based on significant risk factors and validated it using bootstrapping.

Main Results:

• The study included 2324 patients; 6.8% had UGIM.
• Key predictors for UGIM included age > 40, low albumin, low hemoglobin, alarm features, and recent symptom onset.
• The model achieved an AUC of 0.9, with a score of 2 demonstrating 92.5% sensitivity for predicting UGIM.

Conclusions:

• A simple clinical-cum-laboratory test-based model accurately identifies dyspeptic patients at risk for UGIM.
• This validated model can serve as a valuable decision-making tool for endoscopy referrals.