Validation of the C-urea breath test for the initial diagnosis of Helicobacter pylori infection and to confirm eradication after treatment.

Objectives: the breath test with 13C-urea (UBT) is a method widely used in Spain, but its diagnostic accuracy has not been evaluated in a clinical trial until now. Our objective was to validate the UBT (TAU-KIT) both as an initial diagnostic method for the detection of H. pylori infection and as a m...

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Publicado en:Spanish Journal of Gastroenterology / Revista Española de Enfermedades Digestivas Vol. 95; no. 2; pp. 121 - 127
Autores principales: Gisbert JP, Ducons J, Gomollón F, Domínguez-Muñoz JE, Borda F, Miño G, Jiménez I, Vázquez MA, Santolaria S, Gallego S, Iglesias J, Pastor G, Hervas A, Pajares M
Formato: clinical trial research tables/charts Journal Article
Publicado: Aran Ediciones S.A. 2003 Feb
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Aran Ediciones S.A.
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        atl: Validation of the C-urea breath test for the initial diagnosis of Helicobacter pylori infection and to confirm eradication after treatment.
      aug:
        au:
          Gisbert JP
          Ducons J
          Gomollón F
          Domínguez-Muñoz JE
          Borda F
          Miño G
          Jiménez I
          Vázquez MA
          Santolaria S
          Gallego S
          Iglesias J
          Pastor G
          Hervas A
          Pajares M
        affil: Gastrotenterology Unit 'La Princesa' University Hospital, Madrid, Spain
      sug:
        subj:
          Breath Tests Methods
          Helicobacter Infections Diagnosis
          Spain
          Helicobacter Infections Drug Therapy
          Sensitivity and Specificity
          Predictive Value of Tests
          Carbon Diagnostic Use
          Isotopes Diagnostic Use
          Clinical Trials
          Validation Studies
          Confidence Intervals
          Human
      ab: Objectives: the breath test with 13C-urea (UBT) is a method widely used in Spain, but its diagnostic accuracy has not been evaluated in a clinical trial until now. Our objective was to validate the UBT (TAU-KIT) both as an initial diagnostic method for the detection of H. pylori infection and as a method to confirm eradication.Methods: a multi-centre study in 7 Spanish hospitals was performed. A group of dyspeptic patients who had not previously received eradication treatment was included, and a second group of patients with gastric ulcer or upper gastrointestinal bleeding due to peptic ulcer was also included (eradication of H. pylori was confirmed 6 to 8 weeks after treatment completion with omeprazole, clarithromycin and amoxycillin). In both groups an endoscopy was performed with biopsies for histology and rapid urease test. Patients were considered infected if both tests yielded positive results, and not infected when both tests were negative. The UBT 13C-urea (TAU-KIT, Isomed S.L., Madrid, Spain) was performed with citric acid and 100 mg of 13C-urea. The pathologist and persons responsible for endoscopy, urease test and UBT were all unaware of the results from the other diagnostic methods.Results: in the pre-treatment group (36 patients) the prevalence of H. pylori was 72%, the area under the ROC curve for the diagnosis of infection with the UBT was 0.99, and the best cut-off point was 5 units, with the following results: sensitivity= 96% (95% CI = 81-99%), specificity= 100% (69-100%), positive predictive value (PPV) = 100% (87-100%), negative predictive value (NPV) = 92% (59-100%), likelihood ratio (LR) + = 8, and LR- = 0.04. In the post-treatment group (85 patients) the prevalence of H. pylori was 16%, the area under the ROC curve was 0.99, and the best cut point was 4.6, with the following results: sensitivity= 100% (77-100%), specificity = 97% (90-99%), PPV = 88% (62-98%), NPV = 100% (95-100%), LR+ = 35, and LR- = 0.Conclusion: UBT provides excellent accuracy both for the initial diagnosis of H. pylori infection and to confirm eradication after treatment. This abstract was translated into English by the publisher or author.
      pubtype: Periodical
      doctype:
        clinical trial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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