Helicobacter Pylori Testing  Methods - Sensitivity and Specificity



Serology - 85% - 79% - Does not distinguish active versus past infection; use if patient refuses other means of testing. Choosing wisely suggests NOT using serology. NOT recommended if prevalence low.

Urea breath test - 88-95% - 95-100% - Not used at UCSF due to cost

Stool antigen - 94% - 97% - BEST first line test if your patient does not need endoscopy

EGD with biopsy - 95% - 98% - Any red flag symptoms: age > 55-60 with new dyspepsia, FHx of GI cancer, weight loss, dysphagia or odynophagia, GIB or unexplained IDA, jaundice



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