13C‐Urea Breath Test for the Diagnosis of Helicobacter pylori accuracy in Children: A Systematic Review and Meta‐Analysis
Background: The 13C‐urea breath test (13C‐UBT) is a safe, noninvasive and reliable method for diagnosing H. pylori infection in adults. However, the test has shown variable accuracy in the pediatric population, especially in young children. We aimed to carry out a systematic review and meta‐analysis to evaluate the performance of the 13C‐UBT diagnostic test for H. pylori infection in children.
Methods: We conducted a systematic review of the PubMed, Embase and Liliacs databases including studies from January 1998 to May 2009. Selection criteria included studies with at least 30 children and reporting the comparison of 13C‐UBT against a gold standard for H. pylori diagnosis. Thirty‐one articles and 135 studies were included for analysis. Children were stratified in subgroups of <6 and ≥6 years of age, and we considered variables such as type of meal, cutoff value, tracer dose, and delta time for the analysis.
Discussion: The 13C‐UBT performance meta‐analyses showed :
● good accuracy in all ages combined (sensitivity 95.9%, specificity 95.7%, LR+ 17.4, LR− 0.06, diagnostic odds ratio (DOR) 424.9)
● high accuracy in children >6 years (sensitivity 96.6%, specificity 97.7%, LR+ 42.6, LR− 0.04, DOR 1042.7)