title: Real-time diagnosis of H. pylori infection during endoscopy: Accuracy of an innovative tool (EndoFaster).
abstract: BACKGROUND
  EndoFaster is novel device able to perform real-time ammonium measurement in gastric juice allowing H. pylori diagnosis during endoscopy. This large study aimed to validate the accuracy of EndoFaster for real-time H. pylori detection.
  
  
  METHODS
  Consecutive patients who underwent upper endoscopy in two centres were prospectively enrolled. During endoscopy, 4 ml of gastric juice were aspirated to perform automatic analysis by EndoFaster within 90 seconds, and H. pylori was considered present (>62 ppm/ml) or absent (≤62 ppm/ml). Accuracy was measured by using histology as gold standard, and (13)C-urea breath test (UBT) in discordant cases. Accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated.
  
  
  RESULTS
  Overall, 189 patients were enrolled, but in seven (3.4%) the aspirated gastric juice amount was insufficient to perform the test. The accuracy, sensitivity, specificity, PPV, and NPV were 87.4%, 90.3%, 85.5%, 80.2%, 93.1%, respectively, and 92.6%, 97.1%, 89.7%, 85.9%, 98.0%, respectively, when H. pylori status was reclassified according to the UBT result in discordant cases.
  
  
  CONCLUSIONS
  This study found a high accuracy/feasibility of EndoFaster for real-time H. pylori diagnosis. Use of EndoFaster may allow selecting those patients in whom routine gastric biopsies could be avoided.
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
authors.affiliation: Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Zullo
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bizzotto
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spada
authors.affiliation: Gastroenterology Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Maria Elena
authors.initials: ME
authors.lastname: Riccioni
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Clelia
authors.initials: C
authors.lastname: Marmo
authors.affiliation: Endoscopy, "Istituto Clinico Humanitas", Rozzano, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Strangio
authors.affiliation: Deptartment of Internal Medicine and Gastroenterology, Catholic University, Rome, Italy.
authors.forename: Teresa Antonella
authors.initials: TA
authors.lastname: Di Rienzo
authors.affiliation: Deptartment of Internal Medicine and Gastroenterology, Catholic University, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cammarota
authors.affiliation: Deptartment of Internal Medicine and Gastroenterology, Catholic University, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Endoscopy, "Istituto Clinico Humanitas", Rozzano, Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
keywords: EndoFaster; Helicobacter pylori; diagnosis; gastric juice; histology; urea breath test