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Is the Utilization of Helicobacter pylori Stool Antigen Tests Appropriate in an Urban Canadian Population?

Irene Ma1, Maggie Guo1, Dylan R Pillai2,1,3,4

  • 1Calgary Laboratory Services, Calgary, Canada.

American Journal of Clinical Pathology
|March 8, 2020
PubMed

Insights

The Helicobacter pylori stool antigen test (HpSAT) shows varied appropriateness across demographics in Calgary. Some at-risk groups, like recent immigrants, were tested appropriately, while others, like males, may have been undertested, potentially missing cases.

Area of Science:

  • Clinical microbiology
  • Public health surveillance
  • Gastroenterology

Background:

  • The Helicobacter pylori stool antigen test (HpSAT) is a key diagnostic tool.
  • Assessing the appropriateness of diagnostic testing is crucial for healthcare resource allocation and patient outcomes.
  • Understanding testing patterns and positivity rates can reveal disparities in healthcare access and utilization.

Purpose of the Study:

  • To investigate the appropriateness of Helicobacter pylori stool antigen testing in Calgary, Canada.
  • To analyze testing and positivity rates of HpSAT across different sociodemographic groups.
  • To establish a framework for evaluating diagnostic test appropriateness using concordance analysis.

Main Methods:

  • Retrospective analysis of laboratory data for all HpSATs performed in Calgary in 2018.
  • Collection of patient data including age, sex, testing volume, and results.
  • Sociodemographic and geospatial analysis by linking laboratory data with 2016 census data to assess testing appropriateness based on concordance of testing and positivity rates.

Main Results:

  • Over 25,000 HpSATs were conducted in 2018, with an overall positivity rate of 14.7%.
  • Geospatial mapping revealed significant variations in testing and positivity rates across Calgary.
  • Certain groups, such as recent immigrants, showed appropriate testing and high positivity rates, while males appeared undertested relative to their positivity rate.

Conclusions:

  • Concordance analysis of testing and positivity rates is a valuable method for assessing diagnostic test appropriateness.
  • The study identified potential gaps in H. pylori testing, indicating that some at-risk populations may be missed.
  • Findings suggest a need for targeted strategies to improve equitable access to H. pylori diagnostics.
Abstract

Keywords:
Helicobacter pyloriCensus dataGeospatial mappingLaboratory medicineStool antigen test (SAT)

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