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Accuracy of urea breath test in Helicobacter pylori infection: Meta-analysis

World Journal of Gastroenterology 2015年第4期21卷 1305-1314页

作者： Mazen Ferwana Imad Abdulmajeed ali alhajiahmed Wedad Madani Belal Firwana Rim Hasan Osama Altayar Paul J Limburg Mohammad Hassan Murad Bandar Knawy National and Gulf Center for Evidence-Based Health Practice King Saud Bin Abdulaziz University for Health SciencesRiyadh 11426Saudi Arabia Department of Medicine University of Missouri ColumbiaMissouriMO 65211United States Knowledge and Evaluation Research Unit Mayo ClinicRochesterMN 65212United States Knowledge and Evaluation Research Unit Mayo ClinicRochesterMN 55905United States Department of Internal Medicine Allegheny General HospitalPittsburgPA 55905United States Division of Gastroenterology Mayo ClinicRochesterMN 55905United States Division of Preventive Medicine Mayo ClinicRochesterMN 55905United States

AIM: To quantitatively summarize and appraise the available evidence of urea breath test(UBT) use to diagnose Helicobacter pylori(H. pylori) infection in patients with dyspepsia and provide pooled diagnostic accuracy ***: We searched MEDLINE, EMBASE, Cochrane library and other databases for studies addressing the value of UBT in the diagnosis of H. pylori infection. We included cross-sectional studies that evaluated the diagnostic accuracy of UBT in adult patients with dyspeptic symptoms. Risk of bias was assessed using QUADAS(Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Diagnostic accuracy measures were pooled using the random-effects model. Subgroup analysis was conducted by UBT type(13C vs 14C) and by measurement technique(Infrared spectrometry vs Isotope Ratio Mass Spectrometry).RESULTS: Out of 1380 studies identified, only 23 met the eligibility criteria. Fourteen studies(61%) evaluated 13 C UBT and 9 studies(39%) evaluated 14 C UBT. There was significant variation in the type of reference standard tests used across *** sensitivity was 0.96(95%CI: 0.95-0.97) andpooled specificity was 0.93(95%CI: 0.91-0.94). Likelihood ratio for a positive test was 12 and for a negative test was 0.05 with an area under thecurve of 0.985. Meta-analyses were associated with a significant statistical heterogeneity that remained unexplained after subgroup analysis. The included studies had a moderate risk of ***: UBT has high diagnostic accuracy for detecting H. pylori infection in patients with dyspepsia. The reliability of diagnostic meta-analytic estimates however is limited by significant heterogeneity.

关键词： Helicobacter pylori Dyspepsia Breath tests Urea/an

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