Table 1.
The information of included studies.
| Comparison (author) | Evaluable patients (n) | Men (%) | Average age | Prevalence (%) of esophagitis | Reference tests |
Study test | Outcome measure extracted | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Upper endoscopy | pH/pH impedance monitoring |
||||||||||
| AET | Number of reflux events | DeMeester score | Symptom reflux association | ||||||||
| A versus B | |||||||||||
| Frazzoni et al.13 | 121 | 51.89 | NA | 42.33 | Erosion | Total AET > 3.2% | >48 | — | SAP ⩾ 95% or SI ⩾ 50% | MNBI | A cut-off value of 2292 Ω |
| Ravi et al.14 | 55 | 41.38 | 60 | 22.73 | — | Total AET ⩾ 5.0% | — | — | — | Baseline impedance | A cut-off value of 2268 Ω |
| Frazzoni et al.15 | 289 | 45.67 | 50 | 23.53 | Erosion | Total AET >3.2% | — | — | SAP ⩾ 95% or SI ⩾ 50% | MNBI | A cut-off value of 2292 Ω |
| Kandulski et al.16 | 36 | 30.77 | 55 | 30.77 | Erosion | Total AET > 4.2% | — | — | SAP ⩾ 95% or SI ⩾ 50% | Baseline impedance | A cut-off value of 2100 Ω |
| A versus C | |||||||||||
| Hayat et al.17 | 198 | 44.14 | 49.7 | NA | — | Total AET > 4.2% | — | — | SAP ⩾ 95% | Salivary pepsin | At least one sample +ve > 16 ng/ml |
| Saritas Yuksel et al.18 | 47 | 65.52 | 50 | 23.4 | Erosion | Total AET > 4.2% | — | — | — | Salivary pepsin | A cut-off value of +1.0 or greater |
| A versus D | |||||||||||
| Cui et al.19 | 565 | 40.7 | 49.4 | NA | Erosion | — | — | ⩾14.7 | SAP ⩾ 95% | DIS | A cut-off value of 0.9 μm |
| Zhou et al.20 | 576 | 41.67 | 49.3 | 27.04 | Erosion | — | — | ⩾14.7 | SAP ⩾ 95% | DIS | A cut-off value of 0.9 μm |
| Cui et al.21 | 161 | 59.66 | NA | 48.74 | Erosion | — | — | ⩾14.7 | — | DIS | A cut-off value of 0.85 μm |
| Mastracci et al.22 | 139 | 57.14 | 52 | 40.34 | Erosion | Total AET > 5.5% | — | — | — | DIS | Mild and marked DIS |
| Vela et al.23 | 26 | NA | NA | 11.54 | Erosion | Total AET > 5.3% | — | — | SAP ⩾ 95% | DIS | A cut-off value of 0.68 μm |
| A versus E | |||||||||||
| Zhou et al.20 | 636 | 41.67 | 49.3 | 27.04 | Erosion | — | — | ⩾14.7 | SAP ⩾ 95% | GERDQ | A cut-off score of 8 |
| Zavala-Gonzales et al.24 | 252 | 37 | 49.49 | 43.65 | Erosion | Total AET > 4.2% | — | — | SI ⩾ 50% | GERDQ | A cut-off score of 8 |
| Jonasson et al.25 | 169 | 53 | 47.4 | 81.07 | Erosion | Total AET > 5.5%, or upright AET > 6.7%, or supine AET > 6.9% | — | — | SAP ⩾ 95% | GERDQ | A cut-off score of 8 |
| Lacy et al.26 | 177 | 28.2 | 51.00 | 16.87 | — | Total AET > 5.3% | — | — | — | GERDQ | A cut-off score of 8 |
| Jones et al.27 | 308 | 46.43 | 47 | 37.66 | Erosion | Total AET > 5.5% | — | — | SAP ⩾ 95% | GERDQ | A cut-off score of 8 |
| Bai et al.28 | 8065 | 50.1 | 46.3 | 17.79 | Erosion | — | — | — | — | GERDQ | A cut-off score of 8 |
| A versus F | |||||||||||
| Zhou et al.20 | 636 | 41.67 | 49.3 | 27.04 | Erosion | — | — | ⩾14.7 | SAP ⩾ 95% | Esomeprazole, 20 mg BID for 2 weeks | Complete symptom relief |
| Jonasson et al.25 | 124 | 53 | 47.4 | 81.07 | Erosion | Total AET > 5.5%, or upright AET > 6.7%, or supine AET > 6.9% | — | — | SAP ⩾95% | PPI for 4 weeks | Symptoms decrease to 1 day/week |
| Lee et al.29 | 188 | 41.49 | 49.9 | 37.23 | Erosion | — | — | — | — | Lansoprazole, 15 mg/30 mg/60 mg once daily for 2 weeks | Symptom score improved by more than 50% |
| Dent et al.30 | 296 | 46.43 | 47 | 37.66 | Erosion | Total AET > 5.5% | — | — | SAP ⩾ 95% | Esomeprazole, 40 mg daily for 14 ± 3 days | Complete symptom relief |
| Cho et al.31 | 73 | 57.53 | 47 | 63.01 | Erosion | Total AET > 4.4% | — | — | SAP ⩾ 95% | Lansoprazole, 30 mg BID for 2 weeks | Symptom score improved by more than 50% |
| Zheng et al.32 | 27 | 29.63 | 57 | 3.7 | Erosion | Total AET > 4.0% | — | ⩾ 14.0 | SI ⩾ 50% | Esomeprazole, 20 mg BID for 2 weeks | NA |
| Lee et al.33 | 164 | 43.29 | NA | 42.07 | Erosion | — | — | — | — | Rabeprazole, 20 mg/40 mg for 2 weeks | 50% symptom reduction |
| Fan et al.34 | 32 | 37.5 | 47.3 | 0 | — | — | — | ⩾14.7 | SI ⩾ 50% | Rabeprazole, 10 mg BID for 2 weeks | Symptom score reduced by more than a third |
| des Varannes et al.35 | 29 | 40.28 | NA | 31.94 | Erosion | Total AET > 4.2% | — | — | SAP ⩾ 95% or SI ⩾ 50% | Rabeprazole, 20 mg BID for 1 week | The cut-off descriptor of at least a ‘clear improvement’ |
| Aanen et al.36 | 67 | 62.16 | 51 | NA | — | Total AET > 4.2% | — | — | SAP ⩾ 95% or SI ⩾ 50% | Esomeprazole, 40 mg daily for 2 weeks | Adequate symptom suppression |
| Dickman et al.37 | 35 | 65.71 | 55.6 | 34.29 | Erosion | Total AET > 4.2%, or upright AET > 6.0%, or supine AET > 1.2% | Rabeprazole, 20 mg BID for 1 week | Symptom score improved by more than 50% | |||
| Juul-Hansen et al.38 | 52 | 33.85 | 47 | 0 | — | Total AET > 4.0% | — | — | — | Lansoprazole, 60 mg for 1 week | Symptom relief: yes/no |
| Pandak et al.39 | 38 | 42.86 | NA | 26.19 | Erosion | Total AET > 4.2% | — | — | — | Omeprazole, 40 mg/d orally BID for 2 weeks | Symptom score improved by more than two points |
| Juul-Hansen et al.40 | 56 | 31.25 | 54 | 0 | — | Total AET > 4.2% | — | — | — | Lansoprazole 60 mg daily for 1 week | Antacid use decreased by more than 75% |
| Fass et al.41 | 35 | 94.29 | 55 | 100 | Erosion | Total AET > 4.2% | — | — | — | Omeprazole (40 mg a.m. plus 20 mg p.m.) for 1 week | Heartburn score improved by more than 50% |
| Fass et al.42 | 42 | 76.19 | 55.2 | 50 | Erosion | Total AET > 4.2% | — | — | — | Omeprazole (40 mg a.m. plus 20 mg p.m.) for 1 week | Heartburn score improved by more than 50% |
| Bate et al.43 | 58 | 55.07 | 47.4 | 49.28 | — | Total AET > 4.0% | — | — | — | Omeprazole, 40 mg o.m. for 2 weeks | Symptoms improved by at least two grades (or from mild to none) |
| Johnsson et al.44 | 160 | NA | NA | 57.5 | Erosion | Total AET > 4.0% | — | — | — | Omeprazole, 20 mg BID for 1 week | Symptoms decreased by at least one grade |
| Fass et al.45 | 37 | 97.44 | 60.1 | 43.24 | Erosion | Total AET > 4.2% | — | — | — | Omeprazole (40 mg a.m. plus 20 mg p.m.) for 1 week | More than 50% reduction in symptoms |
| Carlsson et al.46 | 225 | 50.1 | 50 | 61 | Erosion | — | — | — | — | Omeprazole, 20 mg for 4 weeks | Complete symptom relief |
| Galmiche, Barthelemy and Hamelin47 | 141 | 44.7 | 50 | 26 | Erosion | — | — | — | — | Omeprazole, 20 mg for 4 weeks | Symptoms decrease to 1 day/week, less than mild |
| Hatlebakk et al.48 | 161 | 57 | 49 | 48 | Erosion | — | — | — | — | Omeprazole, 20 mg for 4 weeks | Symptoms decrease to 1 day/week, less than mild |
| Venables et al.49 | 330 | 52 | 52 | 31 | Erosion | — | — | — | — | Omeprazole, 20 mg for 4 weeks | Symptoms decrease to 1 day/week, less than mild |
| A versus G | |||||||||||
| Ates et al.50 | 268 | NA | NA | 22.76 | Erosion | Total AET > 5.3% | — | — | — | Mucosal impedance | A cut-off value of 2019 Ω |
| Saritas Yuksel et al.51 | 69 | NA | NA | 27.54 | Erosion | Total AET > 5.3% | Mucosal impedance | A cut-off value of 3200 Ω | |||
| F versus E | |||||||||||
| Xu et al.52 | 2014 | 126 | 46.83 | 45.6 | NA | 8-week PPI treatment | GERDQ | A cut-off score of 8 | |||
A: esophageal pH/pH impedance monitoring and/or endoscopy; B: baseline impedance; C: salivary pepsin; D: DIS; E: GERDQ; F: PPI test; G: mucosal impedance.
AET, acid exposure time; BID, twice daily; DIS, dilated intercellular space; GERD, gastroesophageal reflux disease; GERDQ, GERD questionnaire; MNBI, mean nocturnal baseline impedance; NA, not applicable; o.m., every morning; SAP, symptom association probability; SI, symptom index; PPI, proton-pump inhibitor.