Management of non-variceal upper gastrointestinal tract hemorrhage: Controversies and areas of uncertainty

Table 1 Sensitivity, specificity, positive predictive value and negative predictive value for death and rebleeding using 6 common upper gastrointestinal tract hemorrhage scoring systems

Scoring system	Death	Rebleeding
Pre-endoscopy Rockall risk score
Sensitivity	100 (43.8-100)	69.6 (49.1-84.4)
Specificity	18.5 (14.8-22.9)	17.5 (13.8-22.0)
PPV	1.0 (0.4-3)	5.5 (3.4-8.8)
NPV	100 (94.4-100)	89.2 (79.4-94.7)
Post-endoscopy Rockall risk score
Sensitivity	33.3 (6.1-79.2)	87.0 (67.9-95.5)
Specificity	29.6 (25.1-34.6)	31.1 (26.4-36.3)
PPV	0.4 (0.1-2.2)	8.1 (5.3-12.1)
NPV	98.1 (93.4-99.5)	97.2 (92.0-99.0)
Blatchford scoring system
Sensitivity	100 (83.89-100)	94.29 (81.40-98.42)
Specificity	1.83 (0.71-4.61)	0.98 (0.27-3.50)
PPV	8.51 (5.58-12.79)	14.04 (10.17-19.06)
NPV	100 (51.01-100)	50.00 (15.00-85.00)
Forest classification
Sensitivity	85.00 (63.96-94.76)	71.43 (54.95-83.67)
Specificity	50.23 (43.66-56.79)	50.49 (43.68-57.28)
PPV	13.49 (8.6-20.54)	19.84 (13.81-27.65)
NPV	97.35 (92.49-99.10)	91.15 (84.77-95.12)
Cedars-Sinai Medical Center predictive index
Sensitivity	95.00 (76.39-99.11)	80.00 (64.11-89.96)
Specificity	41.55 (35.22-48.17)	41.67 (35.12-48.53)
PPV	12.93 (8.44-19.31)	19.05 (13.52-26.15)
NPV	98.91 (94.09-99.81)	92.39 (85.12-96.26)
Baylor College scoring system
Sensitivity	87.50 (52.91-97.76)	30.77 (12.68-57.63)
Specificity	58.49 (45.09-76.74)	47.92 (34.47-61.67)
PPV	24.14 (12.22-42.11)	13.79 (5.50-30.56)
NPV	96.88 (84.26-99.45)	71.88 (54.63-84.44)

95% confidence intervals are recorded in parentheses. PPV: Positive predictive value; NPV: Negative predictive value.