Screening dyspeptic patients for Helicobacter pylori prior to endoscopy: laboratory or near-patient testing?
- PMID: 9831405
- DOI: 10.1097/00042737-199810000-00005
Screening dyspeptic patients for Helicobacter pylori prior to endoscopy: laboratory or near-patient testing?
Abstract
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.
Similar articles
-
Comparison of serum, salivary, and rapid whole blood diagnostic tests for Helicobacter pylori and their validation against endoscopy based tests.Gut. 1997 Apr;40(4):454-8. doi: 10.1136/gut.40.4.454. Gut. 1997. PMID: 9176070 Free PMC article.
-
Comparison of helisal rapid blood test and 14C-urea breath test in determining Helicobacter pylori status and predicting ulcer disease in dyspeptic patients.Am J Gastroenterol. 1998 Jan;93(1):20-5. doi: 10.1111/j.1572-0241.1998.020_c.x. Am J Gastroenterol. 1998. PMID: 9448167 Clinical Trial.
-
Noninvasive tests as a substitute for histology in the diagnosis of Helicobacter pylori infection.Gastrointest Endosc. 2000 Jul;52(1):20-6. doi: 10.1067/mge.2000.106686. Gastrointest Endosc. 2000. PMID: 10882957 Clinical Trial.
-
High sensitivity and specificity of a laboratory-based serological test, pylori DTect ELISA, for detection of Helicobacter pylori infection.Diagn Microbiol Infect Dis. 2000 Feb;36(2):69-74. doi: 10.1016/s0732-8893(99)00101-7. Diagn Microbiol Infect Dis. 2000. PMID: 10705045
-
An evaluation of near-patient testing for Helicobacter pylori in general practice.Aliment Pharmacol Ther. 1997 Feb;11(1):101-5. doi: 10.1046/j.1365-2036.1997.125296000.x. Aliment Pharmacol Ther. 1997. PMID: 9042980 Clinical Trial.
Cited by
-
Non-invasive diagnostic tests for Helicobacter pylori infection.Cochrane Database Syst Rev. 2018 Mar 15;3(3):CD012080. doi: 10.1002/14651858.CD012080.pub2. Cochrane Database Syst Rev. 2018. PMID: 29543326 Free PMC article.
-
[Study of the validity of "rapid" serology in diagnosing Helicobacter pylori infection].Aten Primaria. 2002 Nov 15;30(8):501-6. doi: 10.1016/s0212-6567(02)79087-2. Aten Primaria. 2002. PMID: 12427373 Free PMC article. Spanish.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical