Managing dyspepsia in the young adult patient: effects of different tests for Helicobacter pylori in a “test-and-scope” approach

Abstract

Aim. To evaluate how different methods for the detection of Helicobacter pylori influence on a “test, score and scope” decision approach in young dyspeptic patients. Results. Complete data from 341 patients (52.2% males) were analyzed. One hundred and ten (32%) were H. pylori-positive by definition. The rapid serology test was true-positive in 64 patients, false-positive in 8, and false-negative in 46. For the EIA IgG serology test, the corresponding results were 99 true-positive, 7 false-positive, and 11 false-negative. If the H. pylori fecal test or urea breath test had been applied, 108 (98%) and 107 (97%) positives would have been correctly detected, respectively, as well as 14 and 7 false positives. Models using test data in a setting of decreasing H. pylori prevalence show that test properties have increasing significance. Conclusions. In a selection strategy for young dyspeptics based on the detection of H. pylori, the choice of test should be made with caution. H. pylori fecal test would probably give the best basis for such selection.

Key Words::

• diagnostic accuracy
• diagnostic test
• dyspepsia
• helicobacter pylori
• sensitivity
• specificity

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.