Predictive value of the official XXXX in general practice - a systematic review.

@entity1 @entity263 @entity0 @entity548 @entity5 @entity2 @entity2286 @entity2531 @entity14 @entity158
INTRODUCTION: The objective of this study was to investigate the evidence for positive predictive value ( @entity2286 ) of alarm symptoms and combinations of symptoms for @entity14 , @entity0 and @entity2 in general practice. METHODS: This study is based on a literature search performed in PubMed, Embase, the Cochrane database and at ClinicalTrials.gov in accordance with the PRISMA guidelines. The main outcome measure used was @entity2286 . RESULTS: A total of 16 eligible studies were identified. The intervals in the brackets refer to the variation of the results in the studies. @entity14 : The @entity2286 of " @entity548 " was high for @entity1 > 60 years (6.6-21.2%), but much lower in younger age groups. For "change in bowel habits" and "significant general symptoms", the @entity2286 was 3.5-8.5%. @entity0 : "Palpable suspected @entity5 " was well supported (8.1-24%). No studies on the predictive value of "pitting of the skin", "papil-areola eczema/ulceration" and "suspect axillary lymph nodes" were found. @entity263 : One study showed a high @entity2286 for positive rectal examination (12%). The value for "lower urinary tract symptoms" was low (1.0-3.0%). @entity2286 for " @entity158 " and "haemospermia" were not found. @entity2 : For "haemoptysis" the @entity2286 increased from 8.4 in @entity1 aged 55 years to 20.4 at the age of > 85 years. @entity2286 for "cough", " @entity2531 " were low (0.4-1.1%). Using a new algorithm that estimates the @entity2286 of combinations of symptoms and risk factors, a higher @entity2286 may be achieved. CONCLUSION: A few of the alarm symptoms show a high @entity2286 , whereas the @entity2286 for some symptoms currently remains unknown. To improve the GPs' diagnostic judgment, a new algorithm for calculating the @entity2286 for combinations of symptoms and risk factors seems promising.
