PMID- 15956000
OWN - NLM
STAT- MEDLINE
DCOM- 20050715
LR  - 20220408
IS  - 0003-9926 (Print)
IS  - 0003-9926 (Linking)
VI  - 165
IP  - 11
DP  - 2005 Jun 13
TI  - Is proton pump inhibitor testing an effective approach to diagnose 
      gastroesophageal reflux disease in patients with noncardiac chest pain?: a 
      meta-analysis.
PG  - 1222-8
AB  - 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.
FAU - Wang, Wei Hong
AU  - Wang WH
AD  - Department of Gastroenterology, Peking University First Hospital, Beijing, China.
FAU - Huang, Jia Qing
AU  - Huang JQ
FAU - Zheng, Ge Fan
AU  - Zheng GF
FAU - Wong, Wai Man
AU  - Wong WM
FAU - Lam, Shiu Kum
AU  - Lam SK
FAU - Karlberg, Johan
AU  - Karlberg J
FAU - Xia, Harry H X
AU  - Xia HH
FAU - Fass, Ronnie
AU  - Fass R
FAU - Wong, Benjamin C Y
AU  - Wong BC
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Arch Intern Med
JT  - Archives of internal medicine
JID - 0372440
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Arch Intern Med. 2006 Jan 23;166(2):247-8; author reply 248-9. PMID: 16432097
CIN - Arch Intern Med. 2006 Jan 23;166(2):248; author reply 248-9. PMID: 16432099
MH  - *Anti-Ulcer Agents/therapeutic use
MH  - Chest Pain/*etiology
MH  - *Diagnostic Techniques, Digestive System
MH  - Gastroesophageal Reflux/complications/*diagnosis/drug therapy
MH  - Humans
MH  - *Proton Pump Inhibitors
MH  - Sensitivity and Specificity
RF  - 50
EDAT- 2005/06/16 09:00
MHDA- 2005/07/16 09:00
CRDT- 2005/06/16 09:00
PHST- 2005/06/16 09:00 [pubmed]
PHST- 2005/07/16 09:00 [medline]
PHST- 2005/06/16 09:00 [entrez]
AID - 165/11/1222 [pii]
AID - 10.1001/archinte.165.11.1222 [doi]
PST - ppublish
SO  - Arch Intern Med. 2005 Jun 13;165(11):1222-8. doi: 10.1001/archinte.165.11.1222.