- Title
- Overdiagnosis of gastro-esophageal reflux disease and underdiagnosis of functional dyspepsia in a USA community
- Creator
- Pleyer, C.; Bittner, H.; Locke III, G. R.; Choung, R. S.; Zinsmeister, A. R.; Schleck, C. D.; Herrick, L. M.; Talley, N. J.
- Relation
- Neurogastroenterology and Motility Vol. 26, Issue 8, p. 1163-1171
- Publisher Link
- http://dx.doi.org/10.1111/nmo.12377
- Publisher
- Wiley-Blackwell Publishing
- Resource Type
- journal article
- Date
- 2014
- Description
- Background: There is symptom overlap between gastro-esophageal reflux disease (GERD) and functional dyspepsia (FD). We aimed to test the hypothesis that FD cases are now more likely mislabeled as GERD. Methods: In subjects from Olmsted County, MN seen at Mayo Clinic: (i) Investigation of GERD and FD diagnosis rates between 1985 and 2009. ; (ii) Assessment of survey-based upper gastrointestinal symptoms between 1988 and 2009. ; (iii) Analysis of patients reporting GERD and/or FD symptoms and subsequently receiving a consistent diagnosis of GERD and/or FD during a medical encounter. ; (iv) Assess the association between PPI use and GERD and/or FD symptoms and between actual diagnoses received. Key Results: (i) Yearly GERD diagnosis rates rose between 1985 and 2009 (325-1866 per 100 000). FD diagnosis rates rose from 45 in 1985, to 964 in 1999 but decreased to 452 per 100 000 in 2009. ; (ii) Reported GERD symptoms did not significantly change between three survey waves in the years 1988-2009 (p = 0.052), whereas FD symptoms slightly increased (p = 0.01). ; (iii) 62.9% of subjects reporting GERD symptoms received a GERD diagnosis, however only 12.5% of subjects reporting FD symptoms received a FD diagnosis. ; (iv) PPI use was associated with documented GERD diagnosis (p < 0.001), however there was no significant association between GERD symptoms and PPI use (p = 0.078). Conclusions & Inferences: We have found evidence supporting a systematic bias away from diagnosing FD, favoring a GERD diagnosis.
- Subject
- functional dyspepsia; gastro-esophageal reflux disease; observer bias
- Identifier
- http://hdl.handle.net/1959.13/1303917
- Identifier
- uon:20759
- Identifier
- ISSN:1350-1925
- Language
- eng
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