A prospective comparison of symptoms and five diagnostic tests in patients with helicobacter pylori positive and negative dyspepsia

The purpose of this study was to compare the sensitivity, specificity and positive and negative predictive values of five diagnostic tests which detect Helicobacter. pylori, to investigate whether there is a difference insymptom severity between H. pylori-positive and -negative patients who present with dyspepsia, and to estimate the true prevalence of H. pylori in our population using misclassification rates of the five diagnostic tests. Fifty-seven patients with dyspepsia who were referred for endoscopy were studied. The diagnostic tests used were culture, histology, rapid-urease test, ¹⁴C-urea test and ELISA. Prior to endoscopy, nine symptoms were scored by the patient using a seven point Likert scale. Thirty-two patients were H. pylori-positive and 25 H. pylori-negative. All the tests performed well, the breath test and ELISA had the best operating characteristics. There were no clinically significant differences in symptom severity and the estimated H. pylori prevalence in our population was 52%.