Screening dyspeptic patients for Helicobacter pylori prior to endoscopy: laboratory or near-patient testing?
Background: It is unclear whether near-patient whole-blood diagnostic tests for Helicobacter pylori are of comparable accuracy to laboratory based ELISA for screening of dyspeptic patients prior to endoscopy.Aim: To compare two ELISA and two whole-blood tests in order to determine whether near-patie...
| Published in: | European Journal of Gastroenterology & Hepatology Vol. 10; no. 10; pp. 843 - 847 |
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| Main Authors: | , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
Lippincott Williams & Wilkins
Oct1998
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=110686755&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110686755 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0954691X 8CE jtl: European Journal of Gastroenterology & Hepatology issn: 0954691X maglogo: N pubinfo: dt: Oct1998 vid: 10 iid: 10 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 110686755 110686755 NLM9831405 110686755 10.1097/00042737-199810000-00005 NLM9831405 110686755 ppf: 843 ppct: 4 formats: tig: atl: Screening dyspeptic patients for Helicobacter pylori prior to endoscopy: laboratory or near-patient testing? aug: au: Asante, Maxwell A. Mendall, Michael A. Finlayson, Caroline Ballam, Lydia Northfield, Timothy Asante, M A Mendall, M A Finlayson, C Ballam, L Northfield, T affil: Departments of Gastroenterology, St George's Hospital Medical School, London, UK sug: subj: Dyspepsia Microbiology Diagnosis, Laboratory Helicobacter Pylori Aged, 80 and Over Aged Adult Hematologic Tests Endoscopy, Digestive System Male Enzyme-Linked Immunosorbent Assay Adolescence False Positive Results Human Sensitivity and Specificity Female Middle Age Predictive Value of Tests Validation Studies Comparative Studies Evaluation Research Multicenter Studies Aged, 80 & over Aged: 65+ years Adult: 19-44 years Adolescent: 13-18 years Middle Aged: 45-64 years Male Female ab: Background: It is unclear whether near-patient whole-blood diagnostic tests for Helicobacter pylori are of comparable accuracy to laboratory based ELISA for screening of dyspeptic patients prior to endoscopy.Aim: To compare two ELISA and two whole-blood tests in order to determine whether near-patient H. pylori diagnostic tests are an acceptable alternative to laboratory based ELISA tests for screening of dyspeptic patients prior to endoscopy.Method: One hundred and seven consecutive patients with dyspepsia (median age, 32 years; range, 16-45 years) were evaluated with Helico-G ELISA, Hmcap ELISA and Helisal whole-blood tests. A further 111 dyspeptic patients (median age, 51 years; range, 16-96 years) were evaluated with the Immunocard whole-blood test only. The 'gold standard' for infection was based on histology and the rapid urease test (CLO).Results: Compared to the Helico-G test, both near-patient tests had a higher false negative rate (23-37% vs 5%, P< 0.003), and lower sensitivity and negative predictive value. The Immunocard had a higher specificity than did the Helisal (87% vs 63%, P=0.006); otherwise both near-patient whole-blood tests had similar performance. At a sensitivity of 95%, the Hmcap ELISA was more specific than the Helico-G ELISA (75% vs 67%) and had fewer false positives (25% vs 32%). The near-patient tests would wrongly classify up to 40% H. pylori positive dyspeptic patients and exclude them from endoscopy, compared to 5-6% for ELISA.Conclusions: Near-patient whole-blood H. pylori diagnostic tests are less accurate and thus not an acceptable alternative to laboratory based ELISA tests. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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