Validation of a rapid whole blood test for diagnosing Helicobacter pylori infection

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# Conflicting results from the Helisal test {#article-title-2} Editor—P Moayyedi and colleagues are not correct in stating that the accuracy of the Helisal test for diagnosing Helicobacter pylori had not been independently evaluated before their report.1 As shown in the table, several groups have now reported their findings. The results show a variation in the accuracy of the test that was not revealed by Moayyedi and colleagues' results. Why are their results rather better than those of others? They do not mention any problems in interpreting the tests, although two groups found 5-10% of tests difficult to read (Stone et al; Lahaie et al (table 1); we also found a similar difficulty. In one study there was disagreement between two observers in 6% of cases (Stone et al (table 1). Another important point omitted by Moayyedi and colleagues was the type of blinding used to ensure that the tests were read independently. Were the Helisal tests read before or after the endoscopy? View this table: Table 1 Accuracy of Helisal test for diagnosing H pylori infection in six studies We are puzzled as to why the authors emphasise the number of endoscopies avoided using a test intended primarily for use in primary care. Whereas screening for H pylori in patients already referred to hospital may prove cost effective, the existing evidence suggests that screening for H pylori in primary care and then referring positive cases for endoscopy is not a cost effective strategy.3 It would be even less so if the Helisal test performs as poorly as others have found. 1. 1.↵1. Moayyeddi P, 2. Carter AM, 3. Catto A, 4. Heppell RM, 5. Grant PJ, 6. Axon ATR . Validation of a rapid whole blood test for diagnosing Helicobacter pylori infection. BMJ 1997;314:119. (11 January.) [OpenUrl][1][FREE Full Text][2] 2. 2.1. Duggan A, 2. Logan RPH, 3. Knifton A, 4. Logan RFA . Accuracy of near-patient blood tests for Helicobacter pylori. Lancet 1996;348:617. [OpenUrl][3][CrossRef][4][PubMed][5][Web of Science][6] 3. 3.↵1. Briggs AH, 2. Sculpher MJ, 3. Logan RPH, 4. Aldous J, 5. Ramsay ME, 6. Baron JH . Cost effectiveness of screening for and eradication of Helicobacter pylori in management of dyspeptic patients under 45 years of age. BMJ 1996;312:1321#5. [OpenUrl][7][Abstract/FREE Full Text][8] # Assessment lacked certain considerations {#article-title-6} Editor—In presenting the results of their validation of the Helisal rapid blood test for diagnosing Helicobacter pylori infection, P Moayyedi and colleagues rightly emphasise that the test needs evaluating in the area in which it is to be used.1 The high sensitivity and specificity found in their study are not … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DMoayyedi%26rft.auinit1%253DP%26rft.volume%253D314%26rft.issue%253D7074%26rft.spage%253D119%26rft.epage%253D119%26rft.atitle%253DValidation%2Bof%2Ba%2Brapid%2Bwhole%2Bblood%2Btest%2Bfor%2Bdiagnosing%2BHelicobacter%2Bpylori%2Binfection%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.314.7074.119%26rft_id%253Dinfo%253Apmid%252F9006471%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=bmj&resid=314/7074/119&atom=%2Fbmj%2F314%2F7095%2F1688.2.atom [3]: {openurl}?query=rft.jtitle%253DLancet%26rft.stitle%253DLancet%26rft.aulast%253DDuggan%26rft.auinit1%253DA.%26rft.volume%253D348%26rft.issue%253D9027%26rft.spage%253D617%26rft.epage%253D617%26rft.atitle%253DAccuracy%2Bof%2Bnear-patient%2Bblood%2Btests%2Bfor%2BHelicobacter%2Bpylori.%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0140-6736%252805%252964835-0%26rft_id%253Dinfo%253Apmid%252F8774595%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [4]: /lookup/external-ref?access_num=10.1016/S0140-6736(05)64835-0&link_type=DOI [5]: /lookup/external-ref?access_num=8774595&link_type=MED&atom=%2Fbmj%2F314%2F7095%2F1688.2.atom [6]: /lookup/external-ref?access_num=A1996VF18600055&link_type=ISI [7]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DBriggs%26rft.auinit1%253DA%2BH%26rft.volume%253D312%26rft.issue%253D7042%26rft.spage%253D1321%26rft.epage%253D1325%26rft.atitle%253DCost%2Beffectiveness%2Bof%2Bscreening%2Bfor%2Band%2Beradication%2Bof%2BHelicobacter%2Bpylori%2Bin%2Bmanagement%2Bof%2Bdyspeptic%2Bpatients%2Bunder%2B45%2Byears%2Bof%2Bage%26rft_id%253Dinfo%253Apmid%252F8646042%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [8]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=312/7042/1321&atom=%2Fbmj%2F314%2F7095%2F1688.2.atom