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. 2023 Oct 4;52:66. doi: 10.1186/s40463-023-00670-5

Table 6.

Literature studies

Authors Ref Years LPR/CT LPR diagnosis Sample time Pepsin analysis Thresholds SE SP PPV NPV Accuracy
Wang 10 2022 112/26 HEMII-pH From morning Rapid pepsin > 45 ng/mL 38.4 84.6 91.5 24.2 55.7
China ≥ 1 HRE 07:00:00 to lateral flow Fasting test
6:00 PM Highest saliva > 45 ng/mL 86.6 80.8 95.1 58.3 73.9
concentration Highest test
Zelenik 9 2021 45/1 HEMII-pH Morning PepTest® ≥ 16 ng/mL 48.0 27.0 63.0 40.0 48.0
Czech > 1 HRE
Zhang 7 2020 26/4 HEMII-pH Morning PepTest® ≥ 16 ng/mL 76.9 25.0 87.0 14.3 87.0
Australia ≥ 2 HRE 1-h post-lunch ≥ 75 ng/mL 57.7 75.0 93.8 21.4 N.P
≥ 6 PRE 1-h post-dinner
When symptoms
Klimara 2 2019 19/7 HEMII-pH Morning ELISA > 1 ng/mL 29.4 50.0 62.5 20.0 42.0
U.S.A > 1 HRE 1-h post-lunch Western blot
> 40 PRE 1-h post-dinner Higesth pepsin
1-h post-breakfast concentration
Weitzendorfer 15 2019 41/29 Restech 3 samples PepTest® > 16 ng/mL 85.4 27.6 62.5 57.1 85.4
Austria Ryan score Highest of > 50 ng/mL 78.1 41.4 65.3 57.1
(> 9.4) 3 samples > 100 ng/mL 68.3 58.6 70.0 56.7
> 150 ng/mL 53.7 69.0 71.0 51.3
> 216 ng/mL 41.5 86.2 81.0 51.0
Hayat 6 2015 111/100 MII-pH Morning PepTest® > 16 ng/mL 77.6 63.2 58.4 80.4 N.P
U.K EAT > 4.2% 1-h post-lunch > 50 ng/mL 67.2 76.3 67.2 76.8
1-h post-dinner > 100 ng/mL 51.7 74.5 54.5 72.3
> 150 ng/mL 41.4 90.8 75.0 69.9
> 210 ng/mL 44.2 96.3 95.7 36.5
Ocak 16 2015 18/2 Dual-probe N.P PepTest® ≥ 16 ng/mL 33.0 100 100 14.2 N.P
Turkey pH testing
EAT > 4.2%
Saritas 17 2012 22/25 Wireless N.P PepTest® ≥ 50 ng/mL 50.0 92.0 85.0 68.0 N.P
U.S.A pH testing
EAT > 4.2%
Potluri 18 2003 3/13 Dual-probe pH testing When symptoms Pepsin assay > 1 ng/mL 100 92.3 N.P N.P N.P
U.S.A ≥ 1 proximal acid
esophageal event

EAT, esophageal acid exposure time; (HE)MII-pH, hypopharyngeal–esophageal multichannel-intraluminal impedance-pH monitoring; HRE, hypopharyngeal reflux event(s); LPR/CT, laryngopharyngeal reflux/controls; NP, not provided; NPV, negative predictive value; PPV, positive predictive value; PRE, proximal esophageal reflux event(s); ref., reference; SE, sensitivity; SP, specificity