Rapid urin test (RAPIRUN) as a simple non-invasive diagnostic tool of H. pylori infection: A meta analysis

Introduction: Several diagnostic tests have been developed to detect Helicobacter pylori (H. pylori) infection which is associated with gastritis, gastric and duodenal ulcers, gastric adenocarcinoma, mucosa-associated lymphoid tissue lymphoma, and generally the symptoms of dyspepsia. The study aim was to systematically review the performance of rapid urine test (RAPIRUN) as a simple non-invasive diagnostic tool of H. pylori infection. Methods: An electronic search was performed on MEDLINE, Cochrane, Clinical Key, HighWire, and ScienceDirect (January 2001–August 2016). The investigators selected studies that directly compared the diagnostic accuracy of RAPIRUN with biopsy as reference, in patients with H. pylori infection. Two reviewers independently evaluated the study eligibility and quality and extracted the outcome data by using pre-defined criteria. The investigators examined the diagnostic accuracy of RAPIRUN based on its sensitivity, specificity, positive predictive value, negative predictive value, and area under the summary receiver operating characteristic curve (AUSROC). Heterogeneity was explored using meta-regression. Results: Of 65 articles identified, 5 studies were eligible. The selected studies showed good sensitivity, specificity, diagnostic odds ratio, and AUROC value. The summary sensitivity value using RAPIRUN for the diagnosis of H. pylori infection was 83% (95% confidence interval [CI]: 0.80–0.87; p = 0.0020). The specificity value was 87% (95% CI: 0.84–0.90; p = 0.0068). Using random effects model, the diagnostic odds ratio of RAPIRUN was 46.01 (95% CI: 16.89–125.37; p = 0.0004). The AUSROC value was 0.9511 (95% CI; standard error [SE]: 0.0311). Conclusion: Our meta-analysis suggests that RAPIRUN has good evidence as a simple non-invasive diagnostic tool in identifying H. pylori infection.