Urea breath test yields accurate results for H. pylori detection in Asian patients
The carbon 13 urea breath test (13C-UBT) is sensitive and accurate for the diagnosis of Helicobacter pylori infection in Asians, as shown in the results of a systematic review and meta-analysis.
Researchers searched multiple online databases for studies evaluating the 13C-UBT diagnostic accuracy for H. pylori infection in an Asian population. They assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
The meta-analysis included 15 study protocols extracted from 11 articles. There was considerable bias noted for six articles in the domain of index test. On the other hand, two articles had unclear risk of bias for patient selection, which was based on an established condition or disease (partial gastrectomy patients and nonulcer dyspepsia patients).
Six of the studies were conducted in Hong Kong, five in Taiwan, two in Japan, and one each in Singapore and Israel. All studies had utilized histology as part of its gold standard of reference. Samples in all but one study comprised adults.
Pooled data revealed that 13C-UBT had sensitivity of 97 percent (95 percent CI, 96–98) and specificity of 96 percent (95–97) for diagnosing H. pylori infection, with significant heterogeneity between studies. Accuracy estimates further improved and heterogeneity significantly reduced after adjusting for the dose (50 mg) and breath sample collection time (20 minutes).
The present data support the test-and-treat strategy for H. pylori infection management, according to the researchers. Additional prevalence and cost-effectiveness studies are needed before this strategy can be adopted into national policy.