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Article: Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain? A meta-analysis

TitleIs proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain? A meta-analysis
Authors
Issue Date2005
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archinternmed.com
Citation
Archives Of Internal Medicine, 2005, v. 165 n. 11, p. 1222-1228 How to Cite?
AbstractBackground: Gastroesophageal reflux disease (GERD) is common in patients with noncardiac chest pain (NCCP). Results of studies evaluating the accuracy of a proton pump inhibitor (PPI) treatment as a diagnostic test for GERD-related NCCP have varied. We evaluated the overall accuracy of this modality. Methods: We searched the PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane databases to May 2004 and included randomized, placebo-controlled studies evaluating the accuracy of findings from PPI testing in the diagnosis of GERD in patients with NCCP. The GERD diagnosis was confirmed by results of endoscopy and/or 24-hour esophageal pH monitoring. A summary diagnostic odds ratio and summary receiver operating characteristic curve analysis were used to estimate the overall accuracy and to explore any contributing factors. Results: Six studies met the inclusion criteria. The over-all sensitivity and specificity of a PPI test were 80% (95% confidence interval [CI], 71%-87%) and 74% (95% CI, 64%-83%), respectively, compared with 19% (95% CI, 12%-29%) and 77% (95% CI, 62%-87%), respectively, in the placebo group. The PPI test showed a significant higher discriminative power, with a summary diagnostic odds ratio of 19.35 (95% CI, 8.54-43.84) compared with 0.61 (95% CI, 0.20-1.86) in the placebo group. The impact of the prevalence of GERD and treatment duration on the accuracy of the test could not be determined because of the lack of an adequate number of studies. Conclusion: The use of PPI treatment as a diagnostic test for detecting GERD in patients with NCCP has an acceptable sensitivity and specificity and could be used as an initial approach by primary care physicians to detect GERD in selected patients with NCCP. ©2005 American Medical Association. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/162859
ISSN
2014 Impact Factor: 17.333
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWang, WHen_HK
dc.contributor.authorHuang, JQen_HK
dc.contributor.authorZheng, GFen_HK
dc.contributor.authorWong, WMen_HK
dc.contributor.authorLam, SKen_HK
dc.contributor.authorKarlberg, Jen_HK
dc.contributor.authorXia, HHXen_HK
dc.contributor.authorFass, Ren_HK
dc.contributor.authorWong, BCYen_HK
dc.date.accessioned2012-09-05T05:24:30Z-
dc.date.available2012-09-05T05:24:30Z-
dc.date.issued2005en_HK
dc.identifier.citationArchives Of Internal Medicine, 2005, v. 165 n. 11, p. 1222-1228en_HK
dc.identifier.issn0003-9926en_HK
dc.identifier.urihttp://hdl.handle.net/10722/162859-
dc.description.abstractBackground: Gastroesophageal reflux disease (GERD) is common in patients with noncardiac chest pain (NCCP). Results of studies evaluating the accuracy of a proton pump inhibitor (PPI) treatment as a diagnostic test for GERD-related NCCP have varied. We evaluated the overall accuracy of this modality. Methods: We searched the PubMed, MEDLINE, EMBASE, CINAHL, and Cochrane databases to May 2004 and included randomized, placebo-controlled studies evaluating the accuracy of findings from PPI testing in the diagnosis of GERD in patients with NCCP. The GERD diagnosis was confirmed by results of endoscopy and/or 24-hour esophageal pH monitoring. A summary diagnostic odds ratio and summary receiver operating characteristic curve analysis were used to estimate the overall accuracy and to explore any contributing factors. Results: Six studies met the inclusion criteria. The over-all sensitivity and specificity of a PPI test were 80% (95% confidence interval [CI], 71%-87%) and 74% (95% CI, 64%-83%), respectively, compared with 19% (95% CI, 12%-29%) and 77% (95% CI, 62%-87%), respectively, in the placebo group. The PPI test showed a significant higher discriminative power, with a summary diagnostic odds ratio of 19.35 (95% CI, 8.54-43.84) compared with 0.61 (95% CI, 0.20-1.86) in the placebo group. The impact of the prevalence of GERD and treatment duration on the accuracy of the test could not be determined because of the lack of an adequate number of studies. Conclusion: The use of PPI treatment as a diagnostic test for detecting GERD in patients with NCCP has an acceptable sensitivity and specificity and could be used as an initial approach by primary care physicians to detect GERD in selected patients with NCCP. ©2005 American Medical Association. All rights reserved.en_HK
dc.languageengen_US
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archinternmed.comen_HK
dc.relation.ispartofArchives of Internal Medicineen_HK
dc.subject.meshAnti-Ulcer Agents - Diagnostic Use - Therapeutic Useen_US
dc.subject.meshChest Pain - Etiologyen_US
dc.subject.meshDiagnostic Techniques, Digestive Systemen_US
dc.subject.meshGastroesophageal Reflux - Complications - Diagnosis - Drug Therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshProton Pumps - Antagonists & Inhibitorsen_US
dc.subject.meshSensitivity And Specificityen_US
dc.titleIs proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain? A meta-analysisen_HK
dc.typeArticleen_HK
dc.identifier.emailKarlberg, J: jpekarl@hkucc.hku.hken_HK
dc.identifier.emailWong, BCY: bcywong@hku.hken_HK
dc.identifier.authorityKarlberg, J=rp00400en_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1001/archinte.165.11.1222en_HK
dc.identifier.pmid15956000en_US
dc.identifier.scopuseid_2-s2.0-21744460530en_HK
dc.identifier.hkuros98382-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-21744460530&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume165en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1222en_HK
dc.identifier.epage1228en_HK
dc.identifier.isiWOS:000229812700002-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridWang, WH=23390847100en_HK
dc.identifier.scopusauthoridHuang, JQ=7403635051en_HK
dc.identifier.scopusauthoridZheng, GF=7402224500en_HK
dc.identifier.scopusauthoridWong, WM=7403972413en_HK
dc.identifier.scopusauthoridLam, SK=55424391900en_HK
dc.identifier.scopusauthoridKarlberg, J=7005218406en_HK
dc.identifier.scopusauthoridXia, HHX=8757161400en_HK
dc.identifier.scopusauthoridFass, R=7103304557en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK

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