H. pylori: stool immunoassay can help diagnose and exclude it

Clinical bottom line (level 4)

Half of patients undergoing gastroscopy have a H. pylori infection.
A stool immunoassay can help diagnose (LR + 12) and exclude H. pylori infection (LR - 0.043) .

Lehmann et al: British Medical Journal 1999; 319 : 1409-

Expires November 2002

The study

Setting: university hospital, Basel

102 patients (aged ?, 57% male) undergoing upper GI endoscopy

Independent unblinded reference standard, applied in all patients from a consecutive ?appropriate spectrum.
Reference standard:

any 2 positive from histology, culture and rapid urease test

Diagnostic test: stool immunoassay: positive if optical density > 0.12

The evidence

pre-test probability of H. pylori infection: 49%, (95% CI: 39% to 59%)

diagnostic test	H. pylori infection	no H. pylori infection	LR+ (95% CI)	post-test probability	LR- (95% CI)	post-test probability
positive stool immunoassay	48	4	12 (4.9 to 32)	92%	0.043 (0.011 to 0.17)	4%
total	50	52

Citation

Lehmann F, Drewe J, Terracciano L, et al: comparison of stool immunoassay with standard methods for detecting Helicobacter pylori infection. British Medical Journal 1999; 319 : 1409-

Search Terms: hand-search
Contributor: Chris Ball, November 1999
Reviewer:

_{Clinical Question.}

_Patient	_{undergoing upper GI endoscopy}
_{Intervention or Exposure}	_{stool immunoassay}
_Outcome	_{H. pylori infection}