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Diagnostic accuracy of tests in pediatric gastroesophageal reflux disease

Rachel J van der Pol1, Marije J Smits, Leonie Venmans

  • 1Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. r.j.vanderpol@amc.nl

The Journal of Pediatrics
|December 11, 2012
PubMed

Insights

The diagnostic accuracy of tests for gastroesophageal reflux disease (GERD) in children is unclear due to poor study quality. More high-quality trials are needed to guide clinical practice for pediatric GERD diagnosis.

Area of Science:

  • Pediatric Gastroenterology
  • Diagnostic Accuracy Research
  • Systematic Review Methodology

Background:

  • Gastroesophageal reflux disease (GERD) is common in infants and children.
  • Accurate diagnosis is crucial for effective management.
  • Current diagnostic methods' utility in pediatric GERD is debated.

Purpose of the Study:

  • To systematically review the diagnostic accuracy of common tests for GERD in children.
  • To compare diagnostic tests against conventional history and physical examination.
  • To evaluate tests in children ≤18 months and >18 months.

Main Methods:

  • Searched Medline, Embase, and Cochrane databases.
  • Included studies assessed pH-metry, pH-impedance, esophagogastroscopy, barium contrast study, scintigraphy, and empirical treatment.
  • Study quality was assessed using QUADAS criteria.

Main Results:

  • Six studies with 408 participants and 145 controls were included.
  • pH-metry was evaluated in all studies; esophagogastroscopy in two.
  • Sensitivity and specificity data were unreliable due to poor methodological quality and study design.

Conclusions:

  • The diagnostic accuracy of tests for pediatric GERD remains uncertain.
  • Clinical practice implications are difficult to determine.
  • Well-designed randomized controlled trials are urgently needed to compare treatment strategies based on diagnostic findings versus clinical symptoms.
Abstract

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