caa a22 4500 397498152 CHVBK 20180308164526.0 cr unu---uuuuu 161202e199509 xx s 000 0 eng 10.1093/fampra/12.3.279 doi (NATIONALLICENCE)oxford-10.1093/fampra/12.3.279 Predictive value of signs and symptoms for colorectal cancer in patients with rectal bleeding in general practice [Elektronische Daten] [Gerda H Fijten, Richard Starmans, Jean WM Muris, Hubert JA Schouten, Geert H Blijham, J André Knottnerus] The aim of the study is to determine the diagnostic value of (combinations of) signs, symptoms and simple laboratory test results for colorectal cancer in patients with rectal bleeding presenting in general practice. Initial complaints and findings were compared with the final diagnoses based on clinical follow-up after at least 1 year. Patients studied were those presenting overt rectal bleeding to the general practitioner (83 GPs in the South of the Netherlands). Outcome measures are sensitivity, specificity, predictive values, odds ratios and a predicition model derived from multiple logistic regression analysis. Age, change in bowel habit and blood mixed with or on stool show a statistically significant independent value in the discrimination between patients with a low and those with a high probability of colorectal cancer. Many other variables did not show predictive value. The prediction model has a sensitivity of 100% and a specificity of 90%. Although the number of patients with colorectal cancer is small (n=9) it was possible to identify three characteristics which can be helpful in the prediction of presence or absence of colorectal cancer in general practice. Application of the model presented might prevent 90% of ‘unnecessary' invasive diagnostic procedures for patients with rectal bleeding who do not have colorectal cancer (true negative). Testing the performance of the model in other general practice populations is recommended. © Oxford University Press Original articles nationallicence Fijten Gerda H. Diagnostic Coordination Centre, University Hospital, Maastricht, The Netherlands, Maastricht, The Netherlands, Maastricht, The Netherlands, Utrecht, The Netherlands aut Starmans Richard Department of General Practice, University of Limburg Maastricht, The Netherlands aut Muris Jean WM Department of General Practice, University of Limburg Maastricht, The Netherlands aut Schouten Hubert JA Department of Methodology and Statistics, University of Limburg Maastricht, The Netherlands aut Blijham Geert H. †Department of Internal Medicine, University Hospital Utrecht, The Netherlands aut Knottnerus J André Department of General Practice, University of Limburg Maastricht, The Netherlands aut Family Practice Oxford University Press 12/3(1995-09), 279-286 0263-2136 12:3<279 1995 12 famprj https://doi.org/10.1093/fampra/12.3.279 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1093/fampra/12.3.279 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fijten Gerda H. Diagnostic Coordination Centre, University Hospital, Maastricht, The Netherlands, Maastricht, The Netherlands, Maastricht, The Netherlands, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Starmans Richard Department of General Practice, University of Limburg Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Muris Jean WM Department of General Practice, University of Limburg Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Schouten Hubert JA Department of Methodology and Statistics, University of Limburg Maastricht, The Netherlands aut NATIONALLICENCE 700 1- Blijham Geert H. †Department of Internal Medicine, University Hospital Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Knottnerus J André Department of General Practice, University of Limburg Maastricht, The Netherlands aut NATIONALLICENCE 773 0- Family Practice Oxford University Press 12/3(1995-09), 279-286 0263-2136 12:3<279 1995 12 famprj Metadata rights reserved CC BY-NC-4.0 http://creativecommons.org/licenses/by-nc/4.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-oxford