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 23 May 2018

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News

PPI test has limited diagnostic value for GERD

The additional value of PPI tests for diagnosing GERD in primary care is limited, reports the latest issue of Alimentary Pharmacology & Therapeutics.

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Dr Aanen and colleagues from the Netherlands assessed the diagnostic accuracy of the proton pump inhibitor (PPI) test in primary care.

The researchers also evaluated the additional value off PPI use over reflux history.

The symptom association probability outcome during 24-hour esophageal pH recording was used as reference test for gastro-oesophageal reflux disease (GERD).

The research team recruited subjects with symptoms suggestive of GERD from primary care.

The sensitivity of the PPI test was 0.9
Alimentary Pharmacology & Therapeutics

After a 24-hour pH recording with calculation of the symptom association probability, subjects started using 40 mg esomeprazole once daily for 13 days.

The PPI was considered positive when the subjects reported adequate symptom suppression.

The researchers found successful 24-hour pH recording in 84 of the 90 subjects.

The symptom association probability was calculable in 74 of subjects.

The team observed that the symptom association probability was positive in 70% of the subjects.

The sensitivity of the PPI test was 0.9, and the specificity was 0.3.

The mean likelihood ratio was 1.2 with little variation over the 13 consecutive PPI test days.

The team noted that the likelihood ratios of GERD symptoms were comparable, ranging around 1.

Dr Aanen's team comments, “In primary care patients with reflux symptoms GERD is highly prevalent.”

“Under these conditions the additional value of short-term treatment with a PPI for diagnosing GERD is limited.”

Aliment Pharmacol Ther 2006: 24(9): 1377
20 October 2006

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