Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: Results of a study in a primary care setting

瞄准：为了决定病人的 rabeprazole 测试的诊断价值，由全科医生看。方法：有 GERD 暗示的症状的 83 个病人被全科医生在这个多中心注册，使随机化并且双窗帘学习。所有病人收到了 rabeprazole (20 mg 出价) 或安慰剂一个星期。GERD 的诊断在内视镜检查法或反常食道的 24-h pH 测试在粘膜裂缝的存在上被建立。如果病人们报导至少，“ 7 点 Likert 上的症状的清楚的改进”可伸缩，测试被认为阳性。结果：为 rabeprazole 和安慰剂的测试的敏感分别地是 83% 和 40% 。相应特性，积极、否定的预兆的价值是 45% 和 67% ， 71% 和 71% ，和 62% 和 35% 分别地。操作特征(巨鸟) 分析的接收装置证实最好差别对待截止对应于对“清楚的改进”的描述。结论：禁止者(PPI ) 测试的质子泵的差的特性不支持如此的一条途径在一个主要照顾背景建立 GERD 的诊断。

AIM： To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners. METHODS： Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in this multi-centre, randomized and doubleblind study. All patients received either rabeprazole （20 mg bid） or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a ＂clear improvement＂ of symptoms on a 7-point Likert scale. RESULTS： The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics （ROC） analysis confirmed that the best discriminatory cut-off corresponded to description of ＂clear improvement＂ CONCLUSION： The poor specificity of the proton-pump inhibitor （PPI） test does not support such an approach to establish a diagnosis of GERD in a primary care setting.