December 2013. Volume 9. Number 4

The validity of diagnostic tests of gastroesophageal reflux disease in childhood is uncertain

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

van der Pol RJ, Smits MJ, Venmans L, Boluyt N, Benninga MA, Tabbers MM. Diagnostic Accuracy of Tests in Pediatric Gastroesophageal Reflux Disease. J Pediatr. 2013;162:983-7.

Reviewers: Ochoa Sangrador C1, Andrés de Llano JM2.
1Servicio de Pediatría. Hospital Virgen de la Concha. Zamora. España.
2Servicio de Pediatría. Hospital General del Río Carrión. Palencia. España.
Correspondence: Carlos Ochoa Sangrador. Email: cochoas@meditex.es
Reception date: 25/07/2013
Acceptance date: 06/09/2013
Publication date: 02/10/2013

Abstract

Authors' conclusions: diagnostic accuracy of tests in children suspected of gastroesophageal reflux disease remains unclear and implications for practice are hard to give. There is an urgent need of well-designed randomized controlled trials where the effect of treatment according to specific signs and symptoms will be compared with the effect of treatment based on the results of additional diagnostic tests, for patient relevant outcomes.

Reviewers' commentary: existing studies not allow us to estimate the accuracy of diagnostic tests used in gastro-esophageal reflux disease. The degree of reflux identified by pH-metry seems not sensitive enough to differentiate clinically diagnosed cases. This suggests that the degree of reflux is only one of the parameters to evaluate, together with clinical information and other diagnostic tests, in the selection of patients who will benefit from treatment of the disease. Clinical trials that assess the utility of available tests in decision-making must be done.

How to cite this article

Ochoa Sangrador C, Andrés de Llano JM. La validez de las pruebas diagnósticas de la enfermedad por reflujo gastroesofágico en la infancia es dudosa. Evid Pediatr. 2013;9:63.

AVC | Critically appraised articles

van der Pol RJ, Smits MJ, Venmans L, Boluyt N, Benninga MA, Tabbers MM. Diagnostic Accuracy of Tests in Pediatric Gastroesophageal Reflux Disease. J Pediatr. 2013;162:983-7.

Reviewers: Ochoa Sangrador C1, Andrés de Llano JM2.
1Servicio de Pediatría. Hospital Virgen de la Concha. Zamora. España.
2Servicio de Pediatría. Hospital General del Río Carrión. Palencia. España.
Correspondence: Carlos Ochoa Sangrador. Email: cochoas@meditex.es
Reception date: 25/07/2013
Acceptance date: 06/09/2013
Publication date: 02/10/2013

How to cite this article

Ochoa Sangrador C, Andrés de Llano JM. La validez de las pruebas diagnósticas de la enfermedad por reflujo gastroesofágico en la infancia es dudosa. Evid Pediatr. 2013;9:63.

References

  1. van der Pol RJ, Smits MJ, van Wijk MP, Omari TI, Tabbers MM, Benninga MA. Efficacy of proton-pump inhibitors in children with gastroesophageal reflux disease: a systematic review. Pediatrics. 2011;127(5):925-35.
  2. Ortega Páez E, Cuestas Montañés E. Reflujo gastroesofágico: los inhibidores de la bomba de protones no mejoran la sintomatología en lactantes. Evid Pediatr. 2012;8:39.
  3. Ravelli AM, Villanacci V, Ruzzenenti N, Grigolato P, Tobanelli P, Klersy C, et al. Dilated intercellular spaces: a major morphological feature of esophagitis. J Pediatr Gastroenterol Nutr. 2006;42(5):510-5.
  4. Cucchiara S, Minella R, D’Armiento F, Franco M, Iervolino C, Campanozzi A, et al. Histologic grading of reflux esophagitis and its relationship with intra-oesophageal and intragastric pH variables. Eur J Gastroenterol Hepatol. 1993;5:621-6.

Related Articles

ED | Can we properly diagnose gastroesophageal reflux in children?

Díaz Martín JJ. ¿Podemos diagnosticar adecuadamente el reflujo gastroesofágico en niños? Evid Pediatr. 2013;9:59.
02/10/2013

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