Access

You are not currently logged in.

Access your personal account or get JSTOR access through your library or other institution:

login

Log in to your personal account or through your institution.

If You Use a Screen Reader

This content is available through Read Online (Free) program, which relies on page scans. Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.

Testing for Helicobacter pylori Infection: Validation and Diagnostic Yield of a near Patient Test in Primary Care

Anne E. Duggan, Catherine Elliott and Richard F. A. Logan
BMJ: British Medical Journal
Vol. 319, No. 7219 (Nov. 6, 1999), pp. 1236-1239
Published by: BMJ
Stable URL: http://www.jstor.org/stable/25186294
Page Count: 4
  • Read Online (Free)
  • Subscribe ($19.50)
  • Cite this Item
Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Preview not available
Preview not available

Abstract

Objective To evaluate the performance of a near patient test for Helicobacter pylori infection in primary care. Design Validation study performed within a randomised trial of four management strategies for dyspepsia. Setting 43 general practices around Nottingham. Subjects 394 patients aged 18-70 years presenting with recent onset dyspepsia. Main outcome measures Results of the FlexSure test compared with an enzyme linked immunosorbent assay (ELISA; HM-CAP) with an identical antigen profile and with results of an earlier validation study in secondary care. Diagnostic yield of patients undergoing endoscopy on the basis of their FlexSure result compared with those of patients referred directly for endoscopy. Results When used in primary care FlexSure test had a sensitivity and specificity of 67% (95% confidence interval 59% to 75%) and 98% (95% to 99%) compared with a sensitivity and specificity of 92% (87% to 97%) and 90% (83% to 97%) when used previously in secondary care. Of the H pylori test and refer group 14% (28/199) were found to have conditions for which H pylori eradication was appropriate compared with 23% (39/170) of the group referred directly for endoscopy. Conclusions When used in primary care the sensitivity of the FlexSure test was significantly poorer than in secondary care. About a third of patients who would have benefited from H pylori eradication were not detected. Near patient tests need to be validated in primary care before they are incorporated into management policies for dyspepsia.

Page Thumbnails

  • Thumbnail: Page 
1236
    1236
  • Thumbnail: Page 
1237
    1237
  • Thumbnail: Page 
1238
    1238
  • Thumbnail: Page 
1239
    1239