Study finds physicians show bias when diagnosing stomach problems

This led a team of researchers at Mayo Clinic, others from the United States, Europe and Australia to question if "observer bias" plays a role in the diagnosis of GERD, compared to a diagnosis of functional dyspepsia. As reported today during the American College of Gastroenterology 2011 Annual Scientific Meeting and Postgraduate Course, such a bias exists and increases the likelihood of a diagnosis of GERD. This theory is supported by the following findings from the study:

• In the last 20 years, the number of GERD diagnoses has increased despite a simultaneous decrease in GERD symptoms.
• In the presence of both functional dyspepsia and GERD symptoms, GERD is diagnosed most commonly.
• GERD is the most likely diagnosis in the presence of functional dyspepsia symptoms only.

"These findings serve as a reminder to all physicians to keep an open mind when patients complain of upper GI pain," says senior author G. Richard Locke, M.D., a Mayo Clinic gastroenterologist. "It is worth considering every possible cause of the symptoms, including the sometimes challenging-to-treat functional dyspepsia. Plus, if we believe the patient's symptoms are caused by GERD, we must confirm that diagnosis."

The study also found that:

• Between 1985 and 2009, diagnosis rates of GERD rose from 325 per 100,000 patients to 1,866.
  
• Symptom reporting for GERD actually decreased from 12 percent during the period from 1988 to 1994, to 7.6 percent in 2008-2009.
  
• Overall functional dyspepsia diagnosis rates rose from 45 in 1985 to 964 in 1999, yet decreased to 452 between 1999 and 2009.
  
• Functional dyspepsia symptom reporting was stable at around 5 percent throughout the various survey periods.
  
• The chance of receiving a GERD diagnosis when reporting GERD symptoms was 63 percent, while the chance of receiving an functional dyspepsia diagnosis when reporting functional dyspepsia symptoms was 12.5 percent.
  
• Forty-five percent of subjects reporting both GERD and functional dyspepsia symptoms were diagnosed with GERD only.
  
• Fifty percent of subjects reporting functional dyspepsia symptoms only were diagnosed with both GERD and functional dyspepsia.

Provided by Mayo Clinic