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The recently published article by Wang et al¹ is a beautiful study, although the presentation and interpretation of the results cause some serious concern. In recent literature there have been 2 other meta-analyses summarizing the use of proton pump inhibitors (PPIs) as a diagnostic test for gastroesophageal reflux disease (GERD), both leading to more attenuated conclusions.^2-3 This, in my opinion, reflects reality better than the conclusions of Wang et al¹ do. In the case of the PPI test, the choice of the outcome measure on effectiveness of treatment should be as close as possible to complete resolution of symptoms because any abdominal symptom is subject to placebo. However, Wang et al¹ chose to consider a 50% symptom reduction enough for testing positive on PPI treatment. Although the authors suggest that the chance of having GERD is increased if more than a 50% symptom reduction in a patient is found, using . . . [Full Text of this Article]

AUTHOR INFORMATION
Mattijs E. Numans, MD, PhD