title: Diagnostic accuracy of the14C-urea breath test in Helicobacter pylori infections: a meta-analysis.
abstract: OBJECTIVE
  To summarize and appraise the available literature regarding the use of the14C-urea breath test in the diagnosis of Helicobacter pylori infections in adult patients with dyspepsia and to calculate pooled diagnostic accuracy measures.
  
  
  METHODS
  We systematically searched the PubMed, EMBASE, Cochrane Library, Chinese Journals Full-text (CNKI) and CBMDisc databases to identify published data regarding the sensitivity, specificity, and other measures of diagnostic accuracy of the14C-urea breath test in the diagnosis of Helicobacter pylori infections in adult patients with dyspeptic symptoms. Risk of bias was assessed using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies)-2 tool. Statistical analyses were performed using Meta-Disc 1.4 software and STATA.
  
  
  RESULTS
  Eighteen studies met the inclusion criteria. Pooled results indicated that the14C-urea breath test showed a diagnostic sensitivity of 0.96 (95% CI 0.95 to 0.96) and specificity of 0.93 (95% CI 0.91 to 0.94). The positive like ratio (PLR) was 12.27 (95% CI 8.17 to 18.44), the negative like ratio (NLR) was 0.05 (95% CI 0.04 to 0.07), and the area under the curve was 0.985. The DOR was 294.95 (95% CI 178.37 to 487.70). The14C-urea breath test showed sufficient sensitivity and specificity for diagnosing Helicobacter pylori infection, but unexplained heterogeneity after meta-regression and several subgroup analyses remained.
  
  
  CONCLUSIONS
  The UBT has high accuracy for diagnosing H. pylori infections in adult patients with dyspepsia. However, the reliability of these diagnostic meta-analytic estimates is limited by significant heterogeneity due to unknown factors.
authors.affiliation: Department of Gastroenterology, The First People's Hospital Of Yichang, China Three Gorges University, 443000, Yichang, China. zqh19890902@163.com.
authors.forename: Qiaohui
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, The First People's Hospital Of Yichang, China Three Gorges University, 443000, Yichang, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Gastroenterology, The First People's Hospital Of Yichang, China Three Gorges University, 443000, Yichang, China.
authors.forename: Yaowei
authors.initials: Y
authors.lastname: Ai
authors.affiliation: Department of Gastroenterology, The First People's Hospital Of Yichang, China Three Gorges University, 443000, Yichang, China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Pan
authors.affiliation: Department of Gastroenterology, The First People's Hospital Of Yichang, China Three Gorges University, 443000, Yichang, China.
authors.forename: Mingwen
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of anesthesiology, Renhe Hospital of Three Gorges University, 443000, Yichang, China.
authors.forename: Jingbo
authors.initials: J
authors.lastname: Han
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods*; D002250:Carbon Radioisotopes; D004415:Dyspepsia / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014508:Urea / Q000032:analysis*
chemical_list: D015415:Biomarkers; D002250:Carbon Radioisotopes; D014508:Urea
keywords: 14C-urea test; Diagnosis; Gastritis; Helicobacter pylori; Meta-analysis