The clinical value of the upper gastrointestinal tract roentgenogram series

We studied the role of the upper gastrointestinal tract roentgenogram series (UGI) in the care of 483 ambulatory patients with varied abdominal complaints. The test was significantly abnormal about 20% of the time, rarely led to changes in therapy, and was ordered inappropriately 30% of the time (according to criteria devised by experts). Regardless of their test results, most patients' symptoms improved in the several months after the test. We created a simple rule, based on the patient's history, that would have led to a decrease in the number of inappropriately ordered tests without significantly compromising care. This decision rule may help to improve the utilization of the UGI by identifying patients who are unlikely to benefit from the test.