Accuracy of radiologic and endoscopic diagnosis of duodenal ulcer

On the basis of results of barium examination and upper gastrointestinal endoscopy four diagnostic criteria of duodenal ulcer can be formed: 1) radiography reveals an ulcer, 2) endoscopy reveals an ulcer, 3) both radiography and endoscopy reveal an ulcer, and 4) radiography and/or endoscopy reveals an ulcer. In a consecutive series of 156 patients the accuracy of each of the four diagnostic criteria was determined using the findings of an experienced specialist in upper gastrointestinal endoscopy as a reference. The predictive value of a positive diagnosis (PVpos) for the four diagnostic criteria was 0.63, 0.88, 1, and 0.68, respectively, and the predictive value of a negative diagnosis (PVneg) for all four criteria was around 0.90. The selection of diagnostic criteria should therefore depend on the clinical problem.