¿Cuál es la utilidad del test de inhibidores de la bomba de protones en el dolor torácico no cardíaco?

Huamán, José Wálter; Aliaga, Verónica; Doménech, Gemma; Videla, Sebastián; Saperas, Esteban

doi:10.1016/j.gastrohep.2014.02.009

Cited by 1 publication

(6 citation statements)

References 27 publications

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“…1). 17–35 The aim of all studies was to diagnose GERD using a PPI as the index test. All trials were prospective in design.…”

Section: Resultsmentioning

confidence: 99%

“…On restricting analysis to studies where PPIs were administered twice daily, pooled sensitivity and specificity estimates were 78% (95% CI, 70%-85%) and 44% (95% CI, 39%-49%), respectively in GERD studies 18,20,26,28,30,34,35. In NCCP, pooled sensitivity and specificity estimates were 77% (95% CI, 68%-85%; I 2 =26%) and 81% (95% CI, 71%-88%; I 2 =20%), respectively 19,22,24,25,29,32,33…”

Section: Resultsmentioning

confidence: 99%

“…Our search strategy identified 9 unique articles not included in prior meta-analyses. 25,26,[29][30][31][32][33][34][35] We minimized spectrum bias by including all forms of GERD. Almost all patients with GERD and NCCP underwent confirmatory testing with both upper endoscopy and esophageal pH monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…The strengths of this meta-analysis include its comprehensive and up-to-date literature review, well-defined inclusion and exclusion criteria, critical appraisal of evidence, and applied standardized criteria to define symptomatic response based on a prespecified meta-analysis protocol. Our search strategy identified 9 unique articles not included in prior meta-analyses 25,26,29–35. We minimized spectrum bias by including all forms of GERD.…”

Section: Discussionmentioning

confidence: 99%

“…18,20,26,28,30,34,35 In NCCP, pooled sensitivity and specificity estimates were 77% (95% CI, 68%-85%; I 2 = 26%) and 81% (95% CI, 71%-88%; I 2 = 20%), respectively. 19,22,24,25,29,32,33 On further analysis, restricting only to studies where GERD was diagnosed by endoscopy and esophageal pH monitoring, only one study was excluded. 31 In the remaining 10 studies, pooled sensitivity and specificity estimates were 75% (95% CI, 69%-80%; I 2 = 0%) and 47% (95% CI, 42%-52%; I 2 = 0%), respectively.…”

Section: Sensitivity Analysesmentioning

confidence: 99%

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Diagnostic Accuracy of the Proton Pump Inhibitor Test in Gastroesophageal Reflux Disease and Noncardiac Chest Pain

Ghoneim

Wang

Chehade

et al. 2022

Journal of Clinical Gastroenterology

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Background: Response to a trial of proton pump inhibitors (PPIs) is currently accepted as a first step in the management of gastroesophageal reflux disease (GERD). However, information on the diagnostic performance of the PPI test is limited. Aim: The aim of this study was to determine the diagnostic accuracy of the PPI test in GERD and noncardiac chest pain (NCCP) and to assess the test performance in erosive reflux disease (ERD) and nonerosive reflux disease (NERD). Methods: Web of Science, Cochrane Controlled Register of Trials (CENTRAL), and MEDLINE were searched for studies reporting the diagnostic accuracy of the PPI test in adult patients with typical GERD and NCCP who underwent evaluation using an accepted reference standard, from January 1, 1950, through February 1, 2021. Subgroup analyses were performed, and the risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: Nineteen studies (GERD=11, NCCP=8) involving 1691 patients were included. In GERD, the PPI test had 79% pooled sensitivity [95% confidence interval (CI), 72%-84%], and 45% pooled specificity (95% CI, 40%-49%). In NCCP, pooled sensitivity and specificity were 79% (95% CI, 69%-86%) and 79% (95% CI, 69%-86%), respectively. In ERD, the PPI test had 76% pooled sensitivity (95% CI, 66%-84%) and 30% pooled specificity (95% CI, 8%-67%). In NERD, the PPI test had 79% pooled sensitivity (95% CI, 70%-86%) and 50% pooled specificity (95% CI, 39%-61%). Conclusions: The PPI test was sensitive in GERD but with suboptimal specificity. The test performed better in GERD-related NCCP. Diagnostic accuracy was comparable in ERD and NERD.

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“…1). 17–35 The aim of all studies was to diagnose GERD using a PPI as the index test. All trials were prospective in design.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%