Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy

Figure 1 PRISMA 2020 flow diagram. This flowchart delineates the progression of information throughout various phases of the systematic review, illustrating the quantities of records identified, included, and excluded, along with the rationales for study exclusion.

Figure 2 QUADAS-2 methodological quality graph. The QUADAS-2 methodological quality graph consists of four sections, each representing one of the key domains assessed.

Figure 3 Forest plot for studies based on the ¹³C-urea breath test for Helicobacter pylori infection in dyspeptic patients. A: Forest plot for overall sensitivity; B: Forest plot for overall specificity. 95%CI: 95% confidence interval.

Figure 4 Forest plot for studies based on the ¹⁴C-urea breath test for Helicobacter pylori infection in dyspeptic patients by time after urea administration. A: Forest plot for overall sensitivity; B: Forest plot for overall specificity. 95%CI: 95% confidence interval.

Figure 5 Summary operating characteristics curve curves for studies based on the ¹³C-urea breath test and the ¹⁴C-urea breath test for Helicobacter pylori infection in dyspeptic patients. The summary operating characteristics curve (SROC) curve is a graphical representation that combines sensitivity and specificity data from multiple studies or diagnostic tests. It illustrates how these measures change with different threshold settings or study parameters. The curve is accompanied by the area under the curve (AUC), which provides a quantitative assessment of the test's overall performance. A higher AUC value indicates better discriminatory ability across tested thresholds. Furthermore, the diagnostic odds ratio (DOR) is derived from the ROC curve and offers an evaluation of the test's diagnostic precision. A higher DOR signifies stronger discriminatory power, reflecting the odds of a positive test result in individuals with the condition compared to those without it. A: SROC curve for studies based on the ¹³C-urea breath test (UBT) for Helicobacter pylori (H. pylori) infection in dyspeptic patients; B: SROC curve for studies based on the ¹⁴C-UBT for H. pylori infection in dyspeptic patients. SROC: Summary operating characteristics curve; AUC: Area under the curve; DOR: Diagnostic odds ratio.

Figure 6 Funnel plots for studies based on ¹³C-urea breath test and ¹⁴C-urea breath test for Helicobacter pylori infection in dyspeptic patients. A: Funnel plot for studies based on ¹³C-urea breath test (UBT); B: Funnel plot for studies based on ¹⁴C-UBT.