To the Editor: In their Rational Clinical Examination article, Dr Moayyedi and colleagues1 discussed the use of the clinical history to distinguish organic from functional dyspepsia. They concluded that diagnosis based on symptoms is of limited use in distinguishing between organic and functional dyspepsia. I am concerned that this conclusion may be misleading if applied to all patients with dyspepsia. It is likely that some outpatients have clinical findings that suggest a very low risk of organic disease. It would therefore be informative if the authors found any studies whose analyses were designed to identify such patients.
Badgett R. Distinguishing Organic and Functional Dyspepsia by History. JAMA. 2006;296(11):1352–1353. doi:10.1001/jama.296.11.1352-a
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