title: Rabeprazole test for the diagnosis of gastro-oesophageal reflux disease: results of a study in a primary care setting.
abstract: OBJECTIVE
  To determine the diagnostic value of the rabeprazole test in patients seen by general practitioners.
  
  
  METHODS
  Eighty-three patients with symptoms suggestive of GERD were enrolled by general practitioners in this multi-centre, randomized and double-blind study. All patients received either rabeprazole (20 mg bid) or a placebo for one week. The diagnosis of GERD was established on the presence of mucosal breaks at endoscopy and/or an abnormal esophageal 24-h pH test. The test was considered to be positive if patients reported at least a "clear improvement" of symptoms on a 7-point Likert scale.
  
  
  RESULTS
  The sensitivities of the test for rabeprazole and the placebo were 83% and 40%, respectively. The corresponding specificity, positive and negative predictive values were 45% and 67%, 71% and 71%, and 62% and 35%, respectively. A receiver operating characteristics (ROC) analysis confirmed that the best discriminatory cut-off corresponded to description of "clear improvement".
  
  
  CONCLUSIONS
  The poor specificity of the proton-pump inhibitor (PPI) test does not support such an approach to establish a diagnosis of GERD in a primary care setting.
authors: Institut des Maladies de l'Appareil Digestif, CIC-INSERM-CHU - NANTES, France.
authors: Stanislas Bruley
authors: SB
authors: des Varannes
authors: Sylvie
authors: S
authors: Sacher-Huvelin
authors: Fabienne
authors: F
authors: Vavasseur
authors: Claude
authors: C
authors: Masliah
authors: Marc
authors: M
authors: Le Rhun
authors: Philippe
authors: P
authors: Aygalenq
authors: Sylvie
authors: S
authors: Bonnot-Marlier
authors: Yves
authors: Y
authors: Lequeux
authors: Jean Paul
authors: JP
authors: Galmiche