The treatment of gastroesophageal reflux disease (GERD) is currently defined as a first step in the management of proton pump inhibitor (PPI) trials. However, there is a dearth of information on the PPI test’s diagnostic effectiveness. The aim of this study was to determine the diagnostic accuracy of the PPI test in GERD and noncardiac chest pain (NCCP) and to assess the test performance in erosive reflux disease (ERD) and nonerosive reflux disease (NERD). From January 1, 1950, through February 1, 2021, the following databases were searched for studies reporting the PPI test’s diagnostic accuracy in adult patients with typical GERD and NCCP who underwent evaluation using an accepted reference standard: Web of Science, Cochrane Controlled Register of Trials (CENTRAL), and MEDLINE. Group-level analyses were performed, and the risk of bias was evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. About 19 studies (GERD=11, NCCP=8) involving 1,691 patients were included. In GERD, the PPI test had 79% pooled sensitivity [95% CI, 72%-84%], and 45% pooled specificity (95% CI, 40%-49%). In NCCP, pooled sensitivity and specificity were 79% (95% CI, 69%-86%) and 79% (95% CI, 69%-86%), respectively. The PPI test had a composite sensitivity of 76% (95% CI, 66%-84%) and a composite specificity of 30% (95% CI, 8%-67%). The PPI test in NERD had a 79% overall sensitivity (95% CI, 70%-86%) and a 50% overall specificity (95% CI, 39%-61%). However, the test’s sensitivity was poor in GERD, while its specificity was adequate. GERD-related NCCP resulted in higher performance on the test. In the ERD, diagnostic accuracy was comparable to that in the NERD.
Source:journals.lww.com/jcge/Abstract/9000/Diagnostic_Accuracy_of_the_Proton_Pump_Inhibitor.97298.aspx
