Dr Talley and colleagues from Canada assessed the efficacy of short-term proton pump inhibitors (PPIs) in non-cardiac chest pain.
The investigative team also assessed the performance of an empirical short-term treatment with PPI to establish a diagnosis of abnormal acid reflux in non-cardiac chest pain.
The team conducted a metaanalysis of English language studies identified by searching MEDLINE, EMBASE, Cochrane Controlled Trials Register from 1966 to 2004.
The investigators also searched abstract books from major gastroenterology meetings between 1993 and 2004.
|Pooled specificity odds ratio for PPI versus 24-hour pH monitoring and endoscopy is 74%|
|American Journal of Gastroenterology|
For the metaanalysis of PPI efficacy in non-cardiac chest pain, the team selected randomized controlled trials comparing PPI therapy with placebo.
The investigative team selected uncontrolled studies comparing the test with a standard reference for the metaanalysis of PPI test performance.
The team reported that 8 studies were included in the PPI efficacy analysis.
The research team found that the pooled risk ratio for continued chest pain after PPI therapy was 0.5 and the overall number needed to treat was 3.
The pooled sensitivity, specificity, and diagnostic odds ratio for the PPI test versus 24-hour pH monitoring and endoscopy were 80%, 74%, and 14%, respectively.
The team noted that all studies were small and that there was evidence of publication bias or other small study effects.
Dr Talley's team concluded, “PPI therapy reduces symptoms in non-cardiac chest pain and may be useful as a diagnostic test in identifying abnormal esophageal acid reflux."