Can preliminary screening of dyspeptic patients allow more effective use of investigational techniques?

A total of 1041 patients with undiagnosed dyspepsia were interviewed to determine whether they required investigation for organic disease. The interviewer, a research assistant without medical qualifications, used a standard data sheet. The information obtained was analysed by computer, and, according to the results, patients were predicted to be at high, medium, or low risk. They were then followed up and the final diagnosis was compared with the risk predicted by computer. Patients predicted to be at low risk had a 10% chance of having ulcer disease and a 0.3% chance of having cancer, whereas patients predicted to be at high risk had a 20% chance of having ulcer disease and a 10% chance of having cancer. Appropriate preliminary screening of patients with acute dyspepsia can separate a group at low risk who will require investigation only if their symptoms do not resolve and a group at high risk requiring urgent outpatient consultation.