A systematic review 1 including 6 studies with a total of 220 subjects was abstracted in DARE. Studies of adult patients with recurrent chest pain and with no known cardiac abnormalities, and in which the diagnosis was confirmed by endoscopy and/or 24-hour oesophageal pH monitoring were eligible for inclusion. In most studies patients used a high dose of a PPI for a maximum of 4 weeks. The pooled estimates for the sensitivity and specificity of a PPI diagnostic test were 0.80 (95% CI: 0.71 to 0.87) and 0.74 (95% CI: 0.64 to 0.83), respectively. The comparative estimates for the placebo group were 0.19 (95% CI: 0.12 to 0.29) and 0.77 (95% CI: 0.62 to 0.87), respectively. The PPI test had significantly higher overall diagnostic accuracy for diagnosing GERD in patients with NCCP than placebo: the pooled diagnostic odds ratio was 19.35 (95% CI: 8.54 to 43.84), compared with 0.61 (95% CI: 0.20 to 1.86, P=0.03).
Comment: The quality of evidence is downgraded by sparse data.
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