Evidence map›Paper›PMID 37055666›Full record

Observational studySurgical endoscopy2023

Pepsin in saliva for the diagnosis of erosive esophagitis post-sleeve gastrectomy: a prospective observational study.

Jinyuan Gan, Yarn Kit Chan, Deepa Chandra Segaran, Jean-Paul Kovalik, Alvin Eng, Phong Ching Lee, Jeremy Tan, Chin Hong Lim

Registry-linked trialAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07607067 (Prospective Pilot Study of Salivary Bile Acids and Pepsin as Predictive Biomarkers of Reflux Disease and Esophageal Injury After Sleeve Gastrectomy), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07607067 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Prospective Pilot Study of Salivary Bile Acids and Pepsin as Predictive Biomarkers of Reflux Disease and Esophageal Injury After Sleeve Gastrectomy

Typeobservational_patient_registrySponsorHospital de MataróRan2026 to 2029Enrolled60ConditionsReflux Disease, Gastro-Esophageal, Sleeve Gastrectomy, Saliva Collection, Reflux Esophagitis (RE)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Jinyuan GanDuke-NUS Medical School, SingHealth, Singapore, Singapore.
Yarn Kit ChanDuke-NUS Medical School, SingHealth, Singapore, Singapore.
Deepa Chandra SegaranDivision of Surgery, Department of Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
Jean-Paul KovalikDivision of Medicine, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Alvin EngDivision of Surgery, Department of Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
Phong Ching LeeDivision of Medicine, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
Jeremy TanDivision of Surgery, Department of Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore, Singapore.
Chin Hong LimDivision of Surgery, Department of Upper Gastrointestinal & Bariatric Surgery, Singapore General Hospital, Singapore, Singapore. limxx504@gmail.com.
Singapore General Hospital · SGSingHealth Duke-NUS Academic Medical Centre · SG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic sleeve gastrectomy (LSG) has become the preferred bariatric procedure in many countries. However, new onset erosive esophagitis (EE) is a major shortcoming. Current recommendation is esophago-gastro-duodenoscopy (EGD) should be performed routinely at 1 year and subsequently every 2-3 years to enable the early detection of Barrett's or esophageal adenocarcinoma. This would put significant strains on resources and costs of bariatric program. Our study assesses the association between and diagnostic value of salivary pepsin concentration and endoscopically proven EE in post-LSG patients as a surrogate for EGD.

methodsTwenty patients on routine post-LSG endoscopy between June and September 2022 were recruited for this correlational pilot study. Under supervision, fasting and post-prandial saliva sample was collected and analyzed by Peptest lateral flow device. EGD examinations were performed, and patients completed a validated 25-item QoLRAD questionnaire.

resultsWe found a significant correlation between positive endoscopy findings of EE and salivary pepsin concentrations. The normal group had a lower mean fasting pepsin level (13.13 ng/mL ± 18.97) versus the EE-group (90.55 ng/mL ± 81.28, p = 0.009) and lower mean post-prandial pepsin level (30.50 ng/mL ± 57.72) versus the EE-group (135.09 ng/mL ± 130.17, p = 0.02). The predictive probabilities from the binary regression of fasting and post-prandial pepsin concentrations yield AUC of 0.955 ± 0.044 (95% CI 0.868 to 1.000, p < 0.001).

conclusionOur study distinctively identified salivary pepsin to have excellent sensitivity and negative predictive value in EE, potentially useful to preclude the need for post-LSG EGD in asymptomatic patients with low salivary pepsin.

Indexed as

EsophagitisGastroesophageal RefluxLaparoscopyObesity, MorbidPeptic UlcerEndoscopy, GastrointestinalGastrectomyHumansPepsin APilot ProjectsSalivaPepsin AErosive esophagitisEsophago-gastro-duodenoscopyGastroesophageal reflux diseaseGERD questionnaireLaparoscopic sleeve gastrectomySalivary pepsin

Identifiers

PMID37055666
OpenAlexW4365459410

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.