Screening for helicobacter pylori

Detalhes bibliográficos
Autor(a) principal: Sousa, Jaime Correia de
Data de Publicação: 2006
Outros Autores: Thomas, Roger
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/1822/8589
Resumo: The aim of this review is to assess whether a screening programme for Helicobacter pylori will be both successful and cost-effective. Method: We searched the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effectiveness; MEDLINE; EMBASE; SilverPlatter, Biological Abstracts and Science Citation Index-Expanded. We used the search terms Helicobacter pylori and (diagnos$ or identif$ or find$) and (systematic review$ or meta-anal$), and searched for articles in all languages and limited the search to humans. Evaluation of the Level of Evidence: We used the rating system of the American Family Physician journal: Level A (randomized controlled trial/meta-analysis); Level B (other evidence); and C (consensus/expert opinion). Results: Serological tests: Antibody levels persist in serum for many years and do not permit us to distinguish between past and present infection or to identify treatment failures. Saliva and urine tests: A saliva test had sensitivity of 81% and specificity of 73%. A urine test had sensitivity of 86-89% and specificity of 69-91%. Breath urea tests: The tests have a high sensitivity and specificity but require expensive equipment. Stool tests: showed a high sensitivity and specificity. The European Helicobacter study group recommends either the breath urea or stool antibody tests in the initial diagnosis of H. pylori. Tests for specific gene sequences showed a high sensitivity and specificity. Endoscopy: is invasive, uncomfortable for patients, and expensive. The cost-effectiveness of tests for H. pylori: The better accuracy of the stool and breath tests, despite their greater cost, make them more cost-effective than the serology or near-patient tests. Conclusions: Tests with good sensitivity and specificity are available. The costs of non-invasive diagnostic tests acceptable to patients have been worked out, and the cost-effective dominance of stool and particularly urea breath tests over serological tests has been determined in a systematic review. What remains is to implement and test further the cost-effectiveness of national testing strategies.
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spelling Screening for helicobacter pyloriHelicobacter PyloriDiagnosisMass ScreeningScreening.mpCost-benefit AanalysisCost-effectiveness.mpMeta-analysisSystematic Review.mpThe aim of this review is to assess whether a screening programme for Helicobacter pylori will be both successful and cost-effective. Method: We searched the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effectiveness; MEDLINE; EMBASE; SilverPlatter, Biological Abstracts and Science Citation Index-Expanded. We used the search terms Helicobacter pylori and (diagnos$ or identif$ or find$) and (systematic review$ or meta-anal$), and searched for articles in all languages and limited the search to humans. Evaluation of the Level of Evidence: We used the rating system of the American Family Physician journal: Level A (randomized controlled trial/meta-analysis); Level B (other evidence); and C (consensus/expert opinion). Results: Serological tests: Antibody levels persist in serum for many years and do not permit us to distinguish between past and present infection or to identify treatment failures. Saliva and urine tests: A saliva test had sensitivity of 81% and specificity of 73%. A urine test had sensitivity of 86-89% and specificity of 69-91%. Breath urea tests: The tests have a high sensitivity and specificity but require expensive equipment. Stool tests: showed a high sensitivity and specificity. The European Helicobacter study group recommends either the breath urea or stool antibody tests in the initial diagnosis of H. pylori. Tests for specific gene sequences showed a high sensitivity and specificity. Endoscopy: is invasive, uncomfortable for patients, and expensive. The cost-effectiveness of tests for H. pylori: The better accuracy of the stool and breath tests, despite their greater cost, make them more cost-effective than the serology or near-patient tests. Conclusions: Tests with good sensitivity and specificity are available. The costs of non-invasive diagnostic tests acceptable to patients have been worked out, and the cost-effective dominance of stool and particularly urea breath tests over serological tests has been determined in a systematic review. What remains is to implement and test further the cost-effectiveness of national testing strategies.Associação Portuguesa dos Médicos de Clínica GeralUniversidade do MinhoSousa, Jaime Correia deThomas, Roger20062006-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/1822/8589eng"Revista Portuguesa de Clínica Geral". ISSN 0870-7103. 22 (2006) 585-589.0870-7103info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-21T12:36:22Zoai:repositorium.sdum.uminho.pt:1822/8589Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T19:32:27.935405Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Screening for helicobacter pylori
title Screening for helicobacter pylori
spellingShingle Screening for helicobacter pylori
Sousa, Jaime Correia de
Helicobacter Pylori
Diagnosis
Mass Screening
Screening.mp
Cost-benefit Aanalysis
Cost-effectiveness.mp
Meta-analysis
Systematic Review.mp
title_short Screening for helicobacter pylori
title_full Screening for helicobacter pylori
title_fullStr Screening for helicobacter pylori
title_full_unstemmed Screening for helicobacter pylori
title_sort Screening for helicobacter pylori
author Sousa, Jaime Correia de
author_facet Sousa, Jaime Correia de
Thomas, Roger
author_role author
author2 Thomas, Roger
author2_role author
dc.contributor.none.fl_str_mv Universidade do Minho
dc.contributor.author.fl_str_mv Sousa, Jaime Correia de
Thomas, Roger
dc.subject.por.fl_str_mv Helicobacter Pylori
Diagnosis
Mass Screening
Screening.mp
Cost-benefit Aanalysis
Cost-effectiveness.mp
Meta-analysis
Systematic Review.mp
topic Helicobacter Pylori
Diagnosis
Mass Screening
Screening.mp
Cost-benefit Aanalysis
Cost-effectiveness.mp
Meta-analysis
Systematic Review.mp
description The aim of this review is to assess whether a screening programme for Helicobacter pylori will be both successful and cost-effective. Method: We searched the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the NHS Database of Abstracts of Reviews of Effectiveness; MEDLINE; EMBASE; SilverPlatter, Biological Abstracts and Science Citation Index-Expanded. We used the search terms Helicobacter pylori and (diagnos$ or identif$ or find$) and (systematic review$ or meta-anal$), and searched for articles in all languages and limited the search to humans. Evaluation of the Level of Evidence: We used the rating system of the American Family Physician journal: Level A (randomized controlled trial/meta-analysis); Level B (other evidence); and C (consensus/expert opinion). Results: Serological tests: Antibody levels persist in serum for many years and do not permit us to distinguish between past and present infection or to identify treatment failures. Saliva and urine tests: A saliva test had sensitivity of 81% and specificity of 73%. A urine test had sensitivity of 86-89% and specificity of 69-91%. Breath urea tests: The tests have a high sensitivity and specificity but require expensive equipment. Stool tests: showed a high sensitivity and specificity. The European Helicobacter study group recommends either the breath urea or stool antibody tests in the initial diagnosis of H. pylori. Tests for specific gene sequences showed a high sensitivity and specificity. Endoscopy: is invasive, uncomfortable for patients, and expensive. The cost-effectiveness of tests for H. pylori: The better accuracy of the stool and breath tests, despite their greater cost, make them more cost-effective than the serology or near-patient tests. Conclusions: Tests with good sensitivity and specificity are available. The costs of non-invasive diagnostic tests acceptable to patients have been worked out, and the cost-effective dominance of stool and particularly urea breath tests over serological tests has been determined in a systematic review. What remains is to implement and test further the cost-effectiveness of national testing strategies.
publishDate 2006
dc.date.none.fl_str_mv 2006
2006-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/1822/8589
url http://hdl.handle.net/1822/8589
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv "Revista Portuguesa de Clínica Geral". ISSN 0870-7103. 22 (2006) 585-589.
0870-7103
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Associação Portuguesa dos Médicos de Clínica Geral
publisher.none.fl_str_mv Associação Portuguesa dos Médicos de Clínica Geral
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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