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Diagnostic value of the proton pump inhibitor test for gastro-oesophageal reflux disease in primary care.
Aliment Pharmacol Ther 2006; 24(9):1377-84AP

Abstract

AIM

To assess the diagnostic accuracy of the proton pump inhibitor test in a primary care population as well as its additional value over reflux history, using the symptom association probability outcome during 24-h oesophageal pH recording as reference test for gastro-oesophageal reflux disease.

METHODS

Subjects with symptoms suggestive of gastro-oesophageal reflux disease were recruited from primary care. After a 24-h pH recording with calculation of the symptom association probability, subjects started using 40 mg esomeprazole once daily for 13 days. The proton pump inhibitor test was considered positive when the subjects reported adequate symptom suppression. Data are presented as means with 95% confidence intervals.

RESULTS

Successful 24-h pH recording was accomplished in 84 of the 90 subjects, while the symptom association probability was calculable in 74. The symptom association probability was positive in 70% of the subjects. The sensitivity of the proton pump inhibitor test was 0.91 (CI 0.78-0.96) and the specificity was 0.26 (CI 0.10-0.49). The mean likelihood ratio was 1.2 (CI 0.9-1.6) with little variation over the 13 consecutive proton pump inhibitor test days. The likelihood ratios of gastro-oesophageal reflux disease symptoms were comparable, ranging around 1.

CONCLUSIONS

In primary care patients with reflux symptoms gastro-oesophageal reflux disease is highly prevalent. Under these conditions the additional value of short-term treatment with a proton pump inhibitor for diagnosing gastro-oesophageal reflux disease is limited.

Authors+Show Affiliations

Gastrointestinal Research Unit, University Medical Center, Utrecht, the Netherlands. m.aanen@umcutrecht.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17059519

Citation

Aanen, M C., et al. "Diagnostic Value of the Proton Pump Inhibitor Test for Gastro-oesophageal Reflux Disease in Primary Care." Alimentary Pharmacology & Therapeutics, vol. 24, no. 9, 2006, pp. 1377-84.
Aanen MC, Weusten BL, Numans ME, et al. Diagnostic value of the proton pump inhibitor test for gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther. 2006;24(9):1377-84.
Aanen, M. C., Weusten, B. L., Numans, M. E., de Wit, N. J., Baron, A., & Smout, A. J. (2006). Diagnostic value of the proton pump inhibitor test for gastro-oesophageal reflux disease in primary care. Alimentary Pharmacology & Therapeutics, 24(9), pp. 1377-84.
Aanen MC, et al. Diagnostic Value of the Proton Pump Inhibitor Test for Gastro-oesophageal Reflux Disease in Primary Care. Aliment Pharmacol Ther. 2006 Nov 1;24(9):1377-84. PubMed PMID: 17059519.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic value of the proton pump inhibitor test for gastro-oesophageal reflux disease in primary care. AU - Aanen,M C, AU - Weusten,B L A M, AU - Numans,M E, AU - de Wit,N J, AU - Baron,A, AU - Smout,A J P M, PY - 2006/10/25/pubmed PY - 2007/5/8/medline PY - 2006/10/25/entrez SP - 1377 EP - 84 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 24 IS - 9 N2 - AIM: To assess the diagnostic accuracy of the proton pump inhibitor test in a primary care population as well as its additional value over reflux history, using the symptom association probability outcome during 24-h oesophageal pH recording as reference test for gastro-oesophageal reflux disease. METHODS: Subjects with symptoms suggestive of gastro-oesophageal reflux disease were recruited from primary care. After a 24-h pH recording with calculation of the symptom association probability, subjects started using 40 mg esomeprazole once daily for 13 days. The proton pump inhibitor test was considered positive when the subjects reported adequate symptom suppression. Data are presented as means with 95% confidence intervals. RESULTS: Successful 24-h pH recording was accomplished in 84 of the 90 subjects, while the symptom association probability was calculable in 74. The symptom association probability was positive in 70% of the subjects. The sensitivity of the proton pump inhibitor test was 0.91 (CI 0.78-0.96) and the specificity was 0.26 (CI 0.10-0.49). The mean likelihood ratio was 1.2 (CI 0.9-1.6) with little variation over the 13 consecutive proton pump inhibitor test days. The likelihood ratios of gastro-oesophageal reflux disease symptoms were comparable, ranging around 1. CONCLUSIONS: In primary care patients with reflux symptoms gastro-oesophageal reflux disease is highly prevalent. Under these conditions the additional value of short-term treatment with a proton pump inhibitor for diagnosing gastro-oesophageal reflux disease is limited. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/17059519/Diagnostic_value_of_the_proton_pump_inhibitor_test_for_gastro_oesophageal_reflux_disease_in_primary_care_ L2 - https://doi.org/10.1111/j.1365-2036.2006.03121.x DB - PRIME DP - Unbound Medicine ER -