Bollschweiler E, Feussner H, Hölscher A H, Siewert J R
Department of Surgery, Technical University of Munich, Klinikum rechts der Isar, Germany.
Dysphagia. 1993;8(2):118-21. doi: 10.1007/BF02266991.
Gastroesophageal reflux disease (GERD) is one of the most frequent benign diseases of the gastrointestinal tract and in some cases the diagnosis may be very difficult. There are many diagnostic procedures but none of them could prove or definitely exclude the disease. The 24-h pH-monitoring is the "gold standard" for detection of gastroesophageal reflux and in many patients the reflux correlates with the GERD. The evaluation of a diagnostic method has to be done in a similar manner to the evaluation of therapeutic study (phase 1 to phase 4). For the definition of the "gold standard" for detection of a special diagnosis (e.g., the gastresophageal reflux disease), the results of phase 3 studies for different methods had to be compared. The method with the best values for sensitivity and specificity is yet to be discovered. Until now, pH monitoring has been the gold standard for the diagnosis of GERD. However, there are many problems connected with using this method in clinical practice.
胃食管反流病（GERD）是胃肠道最常见的良性疾病之一，在某些情况下诊断可能非常困难。有许多诊断方法，但没有一种能证实或明确排除该病。24小时pH监测是检测胃食管反流的“金标准”，在许多患者中反流与胃食管反流病相关。诊断方法的评估必须以与治疗研究评估（1期到4期）类似的方式进行。为了定义特殊诊断（如胃食管反流病）检测的“金标准”，必须比较不同方法的3期研究结果。灵敏度和特异性最佳值的方法尚未发现。到目前为止，pH监测一直是胃食管反流病诊断的金标准。然而，在临床实践中使用这种方法存在许多问题。
