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Good Positive Likelihood Ratio

Helicobactor pylori: Likelihood Ratios

Introduction: From UpToDate (http://www.utdol.com/online/content/topic.do?topicKey=acidpep/4732 ):

The ACG guidelines made the following conclusions:

  • Testing for H. pylori should be performed only if the clinician plans to offer treatment for positive results.
  • * Testing is indicated in patients with active peptic ulcer disease, a past history of documented peptic ulcer or gastric MALT lymphoma.

  • The test-and-treat strategy for H. pylori (ie, test and treat if positive) is a proven management strategy for patients with uninvestigated dyspepsia who are under the age of 55 years and have no "alarm features" (bleeding, anemia, early satiety, unexplained weight loss, progressive dysphagia, odynophagia, recurrent vomiting, family history of GI cancer, previous esophagogastric malignancy).
  • * Deciding which test to use in which situation relies heavily upon whether a patient requires evaluation with upper endoscopy and an understanding of the strengths, weaknesses, and costs of the individual test.

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    Tags: Gastrointestinal Problem Infection Tag this Diagnosis.

    The likelihood ratios of findings for Helicobactor pylori are listed below. See the left navigation bar to change the display.

    Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
    **Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
    Good Positive and Negative Likelihood Ratios
    FindingResult +LR-LR
    [ + ] Antral biopsy urease test + 0 - 180.1
    [ + ] Urea breath test + 0 - 11.60.1
    [ + ] Stool antigen test + 0 - 2.90.2
    [ + ] Serology + 0 - 2.80.2
    [ + ] Biopsy histology + 0 - 70.3
    [ + ] Rapid urease test + 0 - 9.60.4
    Good Positive Likelihood Ratio
    FindingResult +LR-LR
    [ + ] Biopsy culture + 0 - 22.50.6