Review: alarm features in dyspepsia do not have high diagnostic accuracy for predicting upper gastrointestinal cancer
Bibliographic record
Abstract
Vakil N, Moayyedi P, Fennerty MB, et al. Limited value of alarm features in the diagnosis of upper gastrointestinal malignancy: systematic review and meta-analysis. Gastroenterology 2006;131:390–401. [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Q In patients with dyspepsia, what is the accuracy of alarm features (eg, dysphagia, weight loss, or anaemia) for detecting upper gastrointestinal (GI) cancer? Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★★☆ Gastroenterology ★★★★★★☆ ### ![Graphic][5] Data sources: Medline (1966–2003), CINAHL (1982 to Jan 2005), EMBASE/Excerpta Medica (1988 to Jan 2005), and Cochrane Controlled Trials Register (Jan 2005). ### ![Graphic][6] Study selection and assessment: prospective studies that evaluated dyspepsia and alarm symptoms in unselected adults (>16 y of age), included >100 patients, compared symptoms with endoscopic diagnosis, and diagnosed >1 upper GI cancer. Studies were pooled using a random effects model. Study quality was assessed. 18 studies met the selection criteria. ### ![Graphic][7] Outcomes: sensitivity, specificity, and likelihood ratios. Pooled estimates showed that clinical … [1]: {openurl}?query=rft.jtitle%253DGastroenterology%26rft.stitle%253DGastroenterology%26rft.aulast%253DVakil%26rft.auinit1%253DN.%26rft.volume%253D131%26rft.issue%253D2%26rft.spage%253D390%26rft.epage%253D401%26rft.atitle%253DLimited%2Bvalue%2Bof%2Balarm%2Bfeatures%2Bin%2Bthe%2Bdiagnosis%2Bof%2Bupper%2Bgastrointestinal%2Bmalignancy%253A%2Bsystematic%2Breview%2Band%2Bmeta-analysis.%26rft_id%253Dinfo%253Adoi%252F10.1053%252Fj.gastro.2006.04.029%26rft_id%253Dinfo%253Apmid%252F16890592%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1053/j.gastro.2006.04.029&link_type=DOI [3]: /lookup/external-ref?access_num=16890592&link_type=MED&atom=%2Febmed%2F12%2F2%2F55.atom [4]: /lookup/external-ref?access_num=000239704800011&link_type=ISI [5]: /embed/inline-graphic-1.gif [6]: /embed/inline-graphic-2.gif [7]: /embed/inline-graphic-3.gif
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Other design | high |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.065 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.008 |
| Bibliometrics | 0.007 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".