Eikelboom, E. (Ellen) (2014) De kans op een onderliggende somatische aandoening bij somatisch onvoldoende verklaarde lichamelijke klachten (SOLK): een systematische review. thesis, Medicine.
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Abstract
Subject According to earlier research 25-50% of physical symptoms presented at the general practitioner remain somatically unexplained. These patients may get the diagnosis ‘medically unexplained physical symptoms’ (MUPS). It is yet unknown how often still a somatic diagnosis is given for these complaints. The purpose of this study is to report on how often a patient diagnosed with MUS, during diagnostic check-up or follow-up, has an underlying somatic disease that explains the complaints previously labeled as MUPS. In addition to this, the aim is to determine if the type of complaint, the type of diagnostic setting (primary, secondary or tertiary care) in which the study was conducted or the duration of follow-up had any influence on the frequency of misdiagnoses. Methods A systematic literature research was conducted throughout the databases Embase, PsycINFO and Medline and searches of reference lists. Articles concerning the risk of an underlying somatic disease for the same complaints in patients initially diagnosed with MUPS after a diagnostic check-up or follow-up, published between January 1980 and July 2014, were included. Data were extracted by two independent reviewers. As primary outcome measure the weighted precentage of revised diagnoses was calculated. Results In total six diagnostic check-up studies and 17 follow-up studies were included. Misdiagnoses occurred in 7,1% in diagnostic check-up studies and in 4,2% in follow-up studies. Also, differences were present in the avarage rates between the types of complaints. In the categories musculoskeletal and gastro-intestinal in diagnostic check-up studies and in the category multi-complaints in follow-up studies, the frequency of misdiagnoses was found to be the highest. In the secondary care setting in diagnostic check-up studies and in the primary care setting in follow-up studies most diagnoses were revised. In addition, more misdiagnoses were found if the duration of follow-up was relatively short. Conclusion The percentage of underlying somatic diseases in patients previously diagnosed with MUPS is relatively small. Physicians should be less reserved to diagnose a patient with MUPS, so potentially iatrogenic harm may be prevented and patients could be referred earlier for effective MUPS-specific treatment. Although the percentage of misdiagnoses is relatively low, it is advisable to follow-up patients with MUPS during the first year after diagnosis, especially with musculoskeletal complaints, gastro-intestinal complaints and multi-complaints.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Rosmalen, Mw. Prof. Dr. J.G.M. |
| Supervisor name: | Tak, Mw. Dr. L.M. and Interdisciplinair Centrum Psychopathologie en Emotieregulati |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/351 |
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