Members of the Copenhagen Computer Icterus Group are: Beth Bjerregaard, M.D., Stewart Bryant, M.D., Jørgen Hilden, M.D., Jørgen Holst-Christensen, M.D., Torben Stæhr Johansen, M.D., Erik Juhl, M.D., Axel Malchow-Møller, M.D., Peter Matzen, M.D., Linda Mindeholm, medical student, and Carsten Thomsen, M.D.
Differential diagnosis of jaundice: a pocket diagnostic chart
Article first published online: 10 DEC 2008
© 1984 Blackwell Munksgaard
Volume 4, Issue 6, pages 360–371, December 1984
How to Cite
Matzen, P., Malchow-Møller, A., Hilden, J., Thomsen, C., Svendsen, L. B., Gammelgaard, J., Juhl, E. and The Copenhagen Computer Icterus Group (1984), Differential diagnosis of jaundice: a pocket diagnostic chart. Liver, 4: 360–371. doi: 10.1111/j.1600-0676.1984.tb00952.x
- Issue published online: 10 DEC 2008
- Article first published online: 10 DEC 2008
- Accepted for publication 7 May 1984
- bile duct obstruction;
- diagnostic tests;
- differential diagnosis;
ABSTRACT— Based on extensive clinical and clinical chemical information (107 different items) from 1002 jaundiced patients, we developed a diagnostic algorithm which was evaluated on a test sample of another 110 jaundiced patients. A primary classification into categories of obstructive jaundice (probability of obstruction ≥0.80), non-obstructive jaundice (probability of obstruction ≤0.20), and of doubtful causes of jaundice (probability of obstruction: 0.20–0.80) was attempted. Among 234 patients in the data base who were classified as obstructive, 220 (94%) proved to be so, as did 36 (97%) of 37 in the test sample. The corresponding figures for non-obstructive jaundice were 463 (96%) of 483 patients correctly classified in the data base and 47 (92%) of 51 patients in the test sample. Altogether 69% of the patients in the data base and 75% of those in the test sample were correctly classified, in 27% and 20% the cause of jaundice was doubtful, and only 4% and 5%, respectively, were misclassified. A slight majority of the patients in whom the algorithmic diagnoses were doubtful proved obstructive. A close correlation was found between the preliminary diagnoses made by the algorithm and by the clinicians. A secondary classification of the patients by the algorithm into benign versus malignant causes of obstructive jaundice performed equally well in the data base and the test sample.