An evaluation of whole blood testing for Helicobacter pylori in general practice

Background: Rapid whole blood tests for Helicobacter pylori infection were developed to assist in the management of patients with dyspepsia in general practice. However, they have not been extensively tested in this setting. Aim: To investigate the test characteristics of the BM-Test (Helisal Quick Test) when used in general practice. Method: One hundred and ten dyspeptic patients attending local general practitioners were recruited into the study. The BM-Test. was administered by the general practitioner at the screening visit according re, standard instructions supplied with the test kit. The patient was then referred to Nepean or Mornington Peninsula Hospitals for further assessment, including a ¹⁴C-urea breath test. The test kit was forwarded to the appropriate hospital centre for an independent, blinded reading. The sensitivity and specificity of the BM-Test were evaluated against the results of the ¹⁴C-UBT. Results: Based on general practitioner readings, the BM-Test had a sensitivity of 59.3% and a specificity of 90.2%. The positive and negative predictive values were 87.5% and 65.7%, respectively. When based on independent readings, sensitivity rose to 71.2% and specificity fell to 88.2%. The BM-Test was more sensitive for older patients than for younger patients when based on both the general practitioner and independent readings. Conclusion: The BM-Test performs below the generally recommended sensitivity and specificity of 90% required for clinical practice.