休斯敦共识会议:关于美国幽门螺杆菌感染的检测

虽然,美国已有关于幽门螺杆菌(Helicobacter pylori,H.pylori)检测和治疗的指南,但对患者进行治疗前后H.pylori检测的建议通常没有得到遵循。来自美国不同地区研究成人和儿童H.pylori感染处理的11名专家参加了"休斯敦共识会议",并在会议中讨论诊断H.pylori感染的关键因素:确定目标人群进行H.pylori检测;抗生素药物敏感性对检测和治疗的影响;确认H.pylori感染和确认根除治疗结果的合适方法。专家被分为多组,采用改良的Delphi小组讨论法来评定需行H.pylori检测的目标人群,抗生素药物敏感性检测方法和治疗方法、根除治疗后的结果确认及相关检测方法。证据质量和建议强度均采用GRADE系统进行评估。各工作小组的结果将提交给所有小组成员进行最后的共识表决。在专家共识会议之后,这些结论将提交给一个独立的胃肠病学专家小组进行验证,并对会议中提出的29项声明进行认同程度评估。最后的建议是基于现有最佳证据提出,并提供带参考文献的共识声明,以便在全美各地的医疗保健体系中实施。

Houston consensus conference on testing for Helicobacter pylori infection in the United States

Despite the guidelines for detection and treatment of Helicobacter pylori infection, recommendations to test patients before and after therapy were commonly not followed in the United States. At the Houston Consensus Conference, 11 experts on management of adult and pediatric patients with H. pylori, from different geographic regions of the United States, met to discuss key factors in the diagnosis of H. pylori infection, including the identification of appropriate patients for testing, effects of antibiotic susceptibility on the testing and treatment, appropriate methods for confirmation of infection and eradication, and relevant health system considerations. The experts were divided into groups that used a modified Delphi panel approach to assess appropriate patients for testing, testing for antibiotic susceptibility and treatment, and test methods and confirmation of eradication. The quality of evidence and strength of recommendations were evaluated using the GRADE system. The results of the individual workshops were presented for a final consensus vote by all panel members. After the Expert Consensus Development meeting, the conclusions were validated by a separate panel of gastroenterologists, who assessed their levels of agreement with each of the 29 statements developed at the Expert Consensus Development. The final recommendations are provided, on the basis of the best available evidence, and provide consensus statements with supporting literature to implement the testing for H. pylori infection at health care systems across the United States.