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学科主题: 临床医学
题名:
Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain? A meta-analysis
作者: Wang, WH; Huang, JQ; Zheng, GF; Wong, WM; Lam, SK; Karlberg, J; Xia, HHX; Fass, R; Wong, BCY
刊名: ARCHIVES OF INTERNAL MEDICINE
发表日期: 2005-06-13
卷: 165, 期:11, 页:1222-1228
收录类别: SCI
文章类型: Review
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: ESOPHAGEAL PH ; COST-EFFECTIVENESS ; DOSE OMEPRAZOLE ; FOLLOW-UP ; ACID ; ENDOSCOPY ; LANSOPRAZOLE ; SENSITIVITY ; MANOMETRY ; ACCURACY
英文摘要:

Background: 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 overall 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.

语种: 英语
WOS记录号: WOS:000229812700002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/63470
Appears in Collections:北京大学第一临床医学院_消化内科_期刊论文

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作者单位: 1.Univ Arizona, Ctr Hlth Sci, Tucson, AZ USA
2.Univ Hong Kong, Fac Med, Dept Med, Hong Kong, Hong Kong, Peoples R China
3.Univ Hong Kong, Fac Med, Clin Trials Ctr, Hong Kong, Hong Kong, Peoples R China
4.Peking Univ, First Hosp, Dept Gastroenterol, Beijing, Peoples R China
5.So Arizona Vet Affairs Hlth Care Syst, Gastroenterol Sect, Neuroenter Clin Res Grp, Tucson, AZ USA

Recommended Citation:
Wang, WH,Huang, JQ,Zheng, GF,et al. Is proton pump inhibitor testing an effective approach to diagnose gastroesophageal reflux disease in patients with noncardiac chest pain? A meta-analysis[J]. ARCHIVES OF INTERNAL MEDICINE,2005,165(11):1222-1228.
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