Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA.
J Clin Gastroenterol. 2011 May-Jun;45(5):429-35. doi: 10.1097/MCG.0b013e3181f3a48c.
The aim of this prospective study was to determine whether this test changes patient diagnosis, provides new information, or alters patient care.
The wireless pH capsule is widely used to evaluate symptoms of acid reflux, although the clinical utility of this test is unknown.
Before pH capsule placement, referring providers completed a questionnaire requesting indications for the test, symptoms, prior testing, and medication use. A follow-up survey determined whether providers believed that results of the wireless pH test provided new information, changed patient diagnosis or altered patient management.
During a 14-month period, 598 wireless pH capsule studies were conducted; 490 patients were eligible for inclusion, and 309 questionnaires were returned (63%). Mean patient age=48 (±15 y). The most common symptom leading to pH capsule placement was acid reflux (heartburn/regurgitation; 62%), followed by chest pain (11%). Wireless pH capsule results provided new information in 88% of patients, changed the diagnosis in 22%, and altered management in 63%.
This study shows the clinical utility of the wireless pH capsule, with test results frequently providing new information, altering patient management or changing patient diagnoses. Future studies should define specific test characteristics most likely to influence patient care.
本前瞻性研究旨在确定该检测是否改变了患者的诊断,提供了新的信息,或改变了患者的治疗方案。
无线 pH 胶囊广泛用于评估酸反流症状,尽管该检测的临床实用性尚不清楚。
在放置 pH 胶囊之前,转诊医生完成了一份问卷,要求提供检测指征、症状、既往检测和药物使用情况。随后的一项调查确定了医生是否认为无线 pH 检测结果提供了新的信息,改变了患者的诊断或改变了患者的管理。
在 14 个月期间,进行了 598 例无线 pH 胶囊研究;490 名患者符合纳入标准,其中 309 名患者(63%)返回了调查问卷。患者的平均年龄为 48(±15)岁。导致 pH 胶囊放置的最常见症状是酸反流(烧心/反流;62%),其次是胸痛(11%)。无线 pH 胶囊结果为 88%的患者提供了新的信息,改变了 22%的诊断,并改变了 63%的管理。
本研究表明了无线 pH 胶囊的临床实用性,检测结果经常提供新的信息,改变患者的管理或改变患者的诊断。未来的研究应确定最有可能影响患者治疗的特定检测特征。