Screening dyspeptic patients for Helicobacter pylori prior to endoscopy

Asante, Maxwell A.; Mendall, Michael A.; Finlayson, Caroline; Ballam, Lydia; Northfield, T. C.

doi:10.1097/00042737-199810000-00005

Cited by 12 publications

(8 citation statements)

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“…All the evidence to date suggests that they have very much lower sensitivity and specificity compared with a laboratory‐based elisa test. Overall, greater accuracy can be obtained with laboratory‐based tests compared with near‐patient tests 68,69 which at present seem not accurate enough to be routinely recommended 64,68–81 ( Table 5,6).…”

Section: Non‐invasive Diagnosismentioning

confidence: 99%

Invasive and non‐invasive tests for Helicobacter pylori infection

Vaira

Holton

Menegatti

et al. 2000

Aliment Pharmacol Ther

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Summary There are two general ways in which a diagnosis of infection by Helicobacter pylori can be made: by using either an invasive or non‐invasive procedure. The invasive procedures involve an endoscopy and biopsy. A biopsy is essential because often the mucosa may appear macroscopically normal but nevertheless be inflamed. A biopsy is obtained by histological examination, culture, polymerase chain reaction or detection of the presence of urease activity in biopsy material. The non‐invasive tests that can be used to diagnose the infection are serology, detection of labelled metabolic products of urea hydrolysis in the breath (13CO2, 14CO2), the urine or the blood, and detection of H, pylori antigen in a stool specimen. At present no single test can be relied upon to detect definitely colonization by H. pylori, and a combination of two is recommended if this is feasible. The choice of the test to be used is not straightforward and may vary according to the clinical condition and local expertise.

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Section: Non‐invasive Diagnosismentioning

confidence: 99%

Invasive and non‐invasive tests for Helicobacter pylori infection

Vaira

Holton

Menegatti

et al. 2000

Aliment Pharmacol Ther

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“…However, the use of these tests was disapproved at the European Consensus Meeting held in Maastricht [8], as sensitivities and specificities observed to date have, in general, been disappointing. In this respect, some authors have compared ELISA and whole-blood tests 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 and have found that near-patient tests would wrongly classify up to 40% of H. pyloripositive dyspeptic patients and exclude them from endoscopy [34].…”

Section: Type Of Diagnostic Methods To Detect H Pylori Infectionmentioning

confidence: 99%

Helicobacter pylori“Test‐and‐Scope” Strategy for Dyspeptic Patients

Gisbert

2000

Helicobacter

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“…For each of the four medical strategies the rest of the tree structure is identical to the decision tree of the rapid test (Fig. 1 Hospital-based test, HmCap, sensitivity 0.94 [7] Hospital-based test HmCap, specificity 0.75 [7] Rapid test-helisal, sensitivity 0.84 [7] Rapid test-helisal, specificity 0.63 [7] Rapid test-immunocard, sensitivity 0.75 [7] Rapid test-immunocard, specificity 0.87 [7] If positive test, upper endoscopy 0.52 [9] If negative test, symptomatic treatment 0.58 [9] Upper Our patient had paid employment and the opportunity cost was measured as ''production loss. ''…”

Section: Resource Use and Unit Costsmentioning

confidence: 99%

“…In contrast, if the GP sends a blood sample for serological testing, it takes 2-7 days to get the result, and this may delay the treatment and usually demands more follow-up by the GP. In Norway and elsewhere there have been discussions about whether HP rapid tests have sufficient diagnostic accuracy to be used in the office laboratory [7,8]. Thus we aimed to compare two rapid tests, Immunocard and Helisal, and one hospital-based test, HmCap, taking aspects both of diagnostic accuracy and consequences of delayed test results into account.…”

Section: Introductionmentioning

confidence: 99%

Economic consequences of near-patient test results: the case of tests for the Helicobacter Pylori bacterium in dyspepsia

Fauli

Thue

2007

Eur J Health Econ

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We have developed a model for economic evaluation related to the diagnostic accuracy (sensitivity and specificity) of near patient tests used in office laboratories, as opposed to using hospital-based tests. Blood-sample based tests to detect the bacterium Helicobacter Pylori (HP) are useful in diagnosing peptic ulcer, and suitable to illustrate the model. First, general practitioners' initial management plans for a dyspeptic patient are elucidated using a paper vignette survey. Based on survey results, and medical literature, a decision tree is constructed to visualize expected costs and outcomes resulting from using three different HP tests. Tests included are two rapid tests for use in general practice, and one hospital laboratory test for comparison. The tests had different sensitivities and specificities. Then a cost-effectiveness analysis is undertaken from a societal perspective. Finally we use sensitivity analyses to model the decision uncertainty. Estimating for a follow-up period of 120 days, the rapid test with lower sensitivity and specificity than the hospital HP test is cost-effective because the test result is available immediately. Further, in general practice, the rapid test with the highest sensitivity is significantly cost effective compared to the test with the highest specificity when the willingness to pay for each dyspepsia-free day exceeds 42.6 euros. When deciding whether a laboratory analysis should be analyzed in the office laboratory or not, it is important to consider both the diagnostic accuracy of the tests and waiting time for the alternative hospital laboratory result.

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Screening dyspeptic patients for Helicobacter pylori prior to endoscopy

Cited by 12 publications

References 0 publications

Invasive and non‐invasive tests for Helicobacter pylori infection

Invasive and non‐invasive tests for Helicobacter pylori infection

Helicobacter pylori“Test‐and‐Scope” Strategy for Dyspeptic Patients

Economic consequences of near-patient test results: the case of tests for the Helicobacter Pylori bacterium in dyspepsia

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