The diagnostic accuracy of a routine contrast study of the upper gastrointestinal tract

In an attempt to clarify the diagnostic accuracy of routine X-ray studies of the upper gastrointestinal tract, radiological diagnoses were compared with endoscopic findings. The radiological results were classified as 'definite' diagnostic, 'probable' diagnostic and as showing 'subtle changes'. The diagnostic accuracy in the category 'definite' diagnosis was 97.2%. The sensitivity and positive predictive value for radiological diagnosis of routine double contrast X-ray studies was 89% and 80.9%, respectively. In all categories taken together 5.7% of the abnormalities were missed (false negatives). In the categories 'probable' and 'subtle changes', 10.9% of the cases were false positives, due to over reading. Most of the false positive cases appeared to be ulcers with scarring at the lesser curvature of the stomach or the duodenal bulb. Endoscopy is advocated in these cases. 16 refs.; 6 tabs