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Related Experiment Videos

Modified acid reflux test. A benefit and cost analysis.

D R Cummings, H Meshkinpour

    Digestive Diseases and Sciences
    |August 1, 1985
    PubMed
    Summary
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    The modified acid reflux test (MART) is cost-effective for diagnosing gastroesophageal reflux (GER) in patients with atypical symptoms. It frequently altered diagnoses in this group, unlike those with typical GER symptoms.

    Area of Science:

    • Gastroenterology
    • Diagnostic Medicine
    • Health Economics

    Background:

    • Gastroesophageal reflux (GER) diagnosis commonly relies on standard acid reflux testing.
    • The cost-effectiveness of GER diagnostic tests, including the modified acid reflux test (MART), remains unevaluated.
    • Esophageal symptoms necessitate accurate and cost-efficient diagnostic approaches.

    Purpose of the Study:

    • To evaluate the diagnostic utility and cost-effectiveness of the modified acid reflux test (MART).
    • To determine how frequently MART alters clinical diagnosis in patients with esophageal symptoms.
    • To compare diagnostic yield and cost between patients with typical and atypical GER symptoms.

    Main Methods:

    • 184 consecutive patients with esophageal symptoms underwent clinical interviews, esophagram, esophageal manometry, and MART.

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  • Patients were categorized based on typical GER symptoms (heartburn, regurgitation) versus atypical presentation (chest pain, dysphagia).
  • Data were analyzed to assess diagnostic alterations and associated costs of MART.

    • Main Results:

    • Previously unsuspected GER was diagnosed in 63% of patients with atypical GER symptoms.
    • MART did not alter clinical diagnosis in patients presenting with typical GER symptoms.
    • No significant differences were observed in mean lower esophageal sphincter pressures or pH scores between groups.
    • MART proved cost-effective only in the atypical symptom group, with an altered diagnosis cost of $633.00.

    Conclusions:

    • MART is a valuable diagnostic tool, particularly for patients with atypical GER symptoms.
    • The modified acid reflux test demonstrates significant cost-effectiveness in identifying previously unsuspected GER in atypical presentations.
    • Standard GER testing may be less beneficial for patients with typical heartburn or regurgitation symptoms.