Evidence of improvement in deficient gastroenterological diagnosis--a regional experience report

A similar study carried out in 1964-1975 showed that very low diagnostic efficiency in gastroenterology rose at the end of this period, supposedly due to the introduction of modern techniques. The present study was designed to evaluate the effect of new imaging techniques (computerized tomography, ultrasonography, gammagraphy and ERCP) in the routine diagnostic efficiency in the same department of gastroenterology between 1979-1983. The study was carried out in two series. In the first, 217 clinical diagnoses were compared with the autopsy findings, and 488 with the surgical findings in the second series. Diagnostic efficiency proved to be twice as high as 10 years ago (p less than 0.0005); the highest diagnostic level was attained in the upper digestive tract. The threefold improvement in pancreatic disease diagnosis from 22% in the previous study to about 60% now did not attain the same level of accuracy (p less than 0.001). The success was due to a 50% decrease (p less than 0.0005) in the number of false negative diagnoses, while false positives remained at the same level of about 10%. In contrast to earlier findings no great difference was found between younger and older age groups.