Table 1.

Sensitivity, specificity, LR+, and LR− of symptoms associated with oesophagogastric cancer

SymptomSensitivity (95% CI)Specificity (95% CI)LR+ (95% CI)LR−(95% CI)Summary DOR (95% CI)
Anaemia
National databases
  Collins & Altman100.07 (0.05 to 0.08)0.99 (0.99 to 0.99)7.70 (6.46 to 9.19)0.94 (0.93 to 0.95)
  Hippisley-Cox & Coupland110.09 (0.07 to 0.11)0.99 (0.99 to 0.99)8.33 (7.01 to 9.90)0.92 (0.91 to 0.94)
  Stapley et al 160.27 (0.26 to 0.28)0.90 (0.89 to 0.90)2.68 (2.56 to 2.82)0.81 (0.80 to 0.82)6.23 (2.96 to 13.1)a
Endoscopy clinic studies
  Kapoor et al 190.13 (0.06 to 0.23)0.90 (0.89 to 0.92)1.32 (0.71 to 2.48)0.97 (0.88 to 1.06)
  Meineche-Schmidt & Jørgensen130.00 (0.00 to 0.37)0.98 (0.97 to 0.98)2.26 (0.15 to 34.04)0.97 (0.83 to 1.13)
  Salo et al 150.13 (0.06 to 0.24)0.93 (0.92 to 0.93)1.87 (1.01 to 3.44)0.93 (0.85 to 1.02)
  Thomson et al 200.00 (0.00 to 0.98)0.99 (0.98 to 1.00)24.8 (2.08 to 294.1)0.76 (0.34 to 1.69)
  Endoscopy clinic summary estimate0.06 (0.01 to 0.31)0.96 (0.91 to 0.99)1.68 (0.34 to 8.25)0.97 (0.88 to 1.01)1.72 (0.73 to 4.04)
  Summary estimates (all studies)0.12 (0.08 to 0.19)0.97 (0.94 to 0.99)4.32 (2.64 to 7.08)0.90 (0.86 to 0.94)4.79 (2.92 to 7.85)
Pain
National databases
  Collins & Altman100.25 (0.23 to 0.27)0.88 (0.88 to 0.89)2.15 (1.98 to 2.33)0.85 (0.83 to 0.87)
  Hippisley-Cox & Coupland110.23 (0.21 to 0.25)0.91 (0.90 to 0.91)2.42 (2.20 to 2.67)0.85 (0.83 to 0.88)
  Stapley et al 160.12 (0.11 to 0.13)0.96 (0.96 to 0.96)3.04 (2.80 to 3.30)0.92 (0.91 to 0.92)2.89 (2.43 to 3.42)a
Endoscopy clinic studies
  Hansen et al 210.25 (0.01 to 0.81)0.74 (0.70 to 0.77)0.95 (0.17 to 5.21)1.02 (0.58 to 1.80)
  Johannessen et al 120.78 (0.40 to 0.97)0.26 (0.23 to 0.29)1.05 (0.74 to 1.49)0.85 (0.25 to 2.91)
  Numans et al 140.68 (0.43 to 0.87)0.47 (0.43 to 0.50)1.29 (0.94 to 1.76)0.67 (0.35 to 1.31)
  Thomson et al 200.00 (0.00 to 0.98)0.55 (0.52 to 0.58)0.56 (0.05 to 6.19)1.35 (0.61 to 3.02)
  Endoscopy clinic summary estimate0.58 (0.30 to 0.81)0.50 (0.33 to 0.68)1.17 (0.84 to 1.63)0.83 (0.52 to 1.34)1.41 (0.64 to 3.14)
  Summary estimates (all studies)0.41 (0.24 to 0.62)0.75 (0.51 to 0.89)1.64 (1.20 to 2.24)0.78 (0.71 to 0.87)2.09 (1.57 to 2.77)
Weight loss
National databases
  Collins & Altman100.12 (0.11 to 0.13)0.99 (0.99 to 0.99)9.37 (8.27 to 10.6)0.89 (0.87 to 0.90)
  Hippisley-Cox & Coupland110.08 (0.07 to 0.10)0.99 (0.99 to 0.99)8.45 (7.04 to 10.2)0.93 (0.91 to 0.94)
  Stapley et al 160.08 (0.08 to 0.09)0.99 (0.99 to 0.99)9.81 (8.53 to 11.3)0.93 (0.92 to 0.93)10.3 (9.36 to 11.2)a
Endoscopy clinic studies
  Johannessen et al 120.78 (0.40 to 0.97)0.74 (0.71 to 0.76)2.94 (2.04 to 4.23)0.30 (0.09 to 1.03)
  Kapoor et al 190.53 (0.41 to 0.65)0.72 (0.70 to 0.74)1.87 (1.48 to 2.36)0.66 (0.51 to 0.84)
  Meineche-Schmidt & Jørgensen130.38 (0.09 to 0.76)0.87 (0.85 to 0.88)2.81 (1.14 to 6.94)0.72 (0.42 to 1.23)
  Numans et al 140.67 (0.43 to 0.85)0.77 (0.74 to 0.80)2.87 (2.07 to 3.98)0.43 (0.24 to 0.80)
  Salo et al 150.22 (0.13 to 0.34)0.97 (0.97 to 0.98)8.48 (5.34 to 13.5)0.80 (0.71 to 0.91)
  Thomson et al 200.00 (0.00 to 0.98)0.99 (0.99 to 1.00)40.0 (3.22 to 497.0)0.75 (0.34 to 1.68)
  Endoscopy clinic summary estimate0.39 (0.22 to 0.59)0.91 (0.74 to 0.97)4.16 (2.05 to 8.43)0.68 (0.55 to 0.84)6.15 (3.35 to 11.3)
  Summary estimates (all studies)0.25 (0.12 to 0.43)0.96 (0.88 to 0.98)5.46 (3.47 to 8.60)0.79 (0.68 to 0.92)6.91 (4.95 to 9.65)
Dysphagia
National databases
  Collins & Altman100.46 (0.44 to 0.48)0.99 (0.99 to 0.99)53.2 (50.5 to 56.1)0.55 (0.52 to 0.57)
  Hippisley-Cox & Coupland110.32 (0.30 to 0.35)0.99 (0.99 to 0.99)60.3 (55.5 to 65.4)0.68 (0.66 to 0.71)
  Stapley et al 160.32 (0.31 to 0.33)0.99 (0.99 to 1.00)57.6 (49.7 to 66.7)0.68 (0.67 to 0.69)91.4 (84.199)a
Endoscopy clinic studies
  Boulton-Jones et al 220.47 (0.21 to 0.73)0.94 (0.92 to 0.95)7.81 (4.31 to 14.18)0.57 (0.35 to 0.91)
  Kapoor et al 190.59 (0.46 to 0.70)0.67 (0.65 to 0.69)1.77 (1.44 to 2.18)0.62 (0.47 to 0.82)
  Meineche-Schmidt & Jørgensen130.38 (0.09 to 0.76)0.87 (0.85 to 0.88)2.82 (1.14 to 6.97)0.72 (0.42 to 1.23)
  Numans et al 140.62 (0.38 to 0.82)0.79 (0.76 to 0.82)2.96 (2.07 to 4.25)0.48 (0.28 to 0.83)
  Salo et al 150.12 (0.05 to 0.22)0.98 (0.98 to 0.99)6.92 (3.55 to 13.5)0.90 (0.82 to 0.98)
  Thomson et al 200.00 (0.00 to 0.98)0.99 (0.98 to 0.99)19.3 (1.65 to 225.0)0.76 (0.34 to 1.69)
  Endoscopy clinic summary estimate0.32 (0.17 to 0.52)0.92 (0.81 to 0.97)4.32 (2.46 to 7.58)0.73 (0.60 to 0.89)5.91 (3.56 to 9.82)
Dyspepsia
National databases
  Stapley et al 160.17 (0.16 to 0.18)0.98 (0.98 to 0.98)7.45 (6.84 to 8.12)0.85 (0.84 to 0.86)8.81 (8.02 to 9.67)
Endoscopy clinic studies
  Boulton-Jones et al 220.53 (0.27 to 0.79)0.20 (0.18 to 0.23)0.67 (0.41 to 1.07)2.34 (1.34 to 4.07)
  Meineche-Schmidt & Jørgensen130.50 (0.16 to 0.84)0.80 (0.79 to 0.82)2.55 (1.27 to 5.11)0.62 (0.31 to 1.24)
  Numans et al 140.35 (0.15 to 0.59)0.36 (0.32 to 0.39)0.55 (0.30 to 0.99)1.81 (1.30 to 2.53)
  Salo et al 150.35 (0.24 to 0.48)0.49 (0.48 to 0.50)0.69 (0.50 to 0.96)1.32 (1.11 to 1.58)
  van Kerkhoven et al 230.70 (0.47 to 0.87)0.39 (0.37 to 0.42)1.15 (0.87 to 1.51)0.77 (0.42 to 1.44)
  Voutilainen et al 240.18 (0.04 to 0.43)0.61 (0.59 to 0.63)0.45 (0.16 to 1.27)1.35 (1.08 to 1.68)
  Endoscopy clinic summary estimate0.42 (0.29 to 0.56)0.48 (0.31 to 0.65)0.79 (0.55 to 1.15)1.23 (0.86 to 1.74)0.65 (0.32 to 1.33)
Nausea/vomiting/bloating
National databases
  Stapley et al 160.13 (0.12 to 0.14)0.98 (0.98 to 0.98)6.76 (6.14 to 7.45)0.89 (0.88 to 0.89)7.63 (6.88 to 8.46)
Endoscopy clinic studies
  Hansen et al 210.00 (0.00 to 0.60)0.73 (0.69 to 0.77)0.37 (0.03 to 5.18)1.23 (0.91 to 1.65)
  Johannessen et al 120.33 (0.07 to 0.70)0.56 (0.53 to 0.59)0.76 (0.30 to 1.91)1.19 (0.75 to 1.90)
  Numans et al 140.38 (0.18 to 0.62)0.76 (0.72 to 0.78)1.56 (0.89 to 2.72)0.82 (0.58 to 1.15)
  Salo et al 150.01 (0.00 to 0.08)0.99 (0.98 to 0.99)1.05 (0.15 to 7.40)1.00 (0.97 to 1.03)
  Thomson et al 200.00 (0.00 to 0.98)0.82 (0.80 to 0.85)1.41 (0.13 to 15.6)0.91 (0.41 to 2.03)
  Endoscopy clinic summary estimate0.17 (0.05 to 0.46)0.84 (0.60 to 0.94)1.07 (0.52 to 2.19)0.99 (0.85 to 1.15)1.08 (0.46 to 2.57)
Reflux: National databases
  Stapley et al 160.11 (0.11 to 0.12)0.98 (0.98 to 0.99)7.22 (6.49 to 8.04)0.90 (0.89 to 0.91)
Endoscopy clinic studies
  Boulton-Jones et al 220.00 (0.00 to 0.22)0.86 (0.84 to 0.88)0.22 (0.01 to 3.42)1.13 (1.03 to 1.24)
  Hansen et al 210.50 (0.07 to 0.93)0.72 (0.68 to 0.75)1.78 (0.66 to 4.78)0.70 (0.26 to 1.86)
  Johannessen et al 120.33 (0.07 to 0.70)0.49 (0.46 to 0.52)0.65 (0.26 to 1.65)1.36 (0.86 to 2.18)
  Numans et al 140.57 (0.34 to 0.78)0.59 (0.55 to 0.62)1.39 (0.95 to 2.03)0.73 (0.44 to 1.20)
  Salo et al 150.15 (0.07 to 0.25)0.76 (0.75 to 0.77)0.62 (0.35 to 1.09)1.12 (1.01 to 1.24)
  Thomson et al 201.00 (0.03 to 1.00)0.62 (0.59 to 0.65)1.99 (0.89 to 4.44)0.40 (0.04 to 4.43)
  van Kerkhoven et al 230.52 (0.31 to 0.73)0.52 (0.50 to 0.55)1.09 (0.74 to 1.62)0.91 (0.59 to 1.41)
  Voutilainen et al 240.00 (0.00 to 0.20)0.89 (0.88 to 0.90)0.25 (0.02 to 3.89)1.09 (1.01 to 1.18)
  Endoscopy clinic summary estimate0.23 (0.10 to 0.46)0.70 (0.59 to 0.80)0.78 (0.47 to 1.28)1.09 (0.97 to 1.24)0.71 (0.38 to 1.32)

  • ↵a Univariate random effects meta-analysis. DOR = diagnostic odds ratio. LR+ = positive likelihood ratio. LR− = negative likelihood ratio.