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The appropriate approach for treating dyspepsia is controversial. Empirical therapy is often recommended for younger patients without alarm symptoms. To evaluate the diagnostic value of alarm symptoms for upper gastrointestinal (UGI) malignancy, investigators in the Netherlands performed a meta-analysis of 17 case-control studies (1552 patients) and 9 cohort studies (16,161 patients) that reported the prevalence of alarm symptoms in patients with and without malignancy. Alarm symptoms were defined as dysphagia, weight loss, bleeding, anemia, nausea, and vomiting. Pooled estimates of the prevalence, sensitivity, specificity, and predictive values were estimated for individual alarm symptoms and for the presence of any alarm symptom.
The mean …