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AIM: To evaluate the diagnostic accuracy and clinical utility of a new ELISA (URINELISA) test for detecting Helicobacter pylori(H pylori) antibody in the urine of Taiwanese population.METHODS: In this prospective study, 317 consecutive dyspeptic patients (171 men, 146 women; mean age,51.0 years) were included. They underwent gastroendoscopy for evaluation. Invasive tests, including culture, histology,and rapid urease test (RUT), and non-invasive 13C-urea breath test were preformed. At the same time, urine specimens were collected for URINELISA. The status of H pylori infection was considered as positive when either culture was positive, or when two of the other, RUT,histology or 13C-UBT, were positive.RESULTS: The sensitivity, specificity, positive predictive value, and negative predictive value of URINELISA are 91.7% (211/230), 90.8% (79/87), 96.3% (211/219), and 80.6% (79/98) respectively.CONCLUSION: This URINELISA test is reliable, inexpensive and easy-to-use. The high diagnostic accuracy warrants the use of URINELISA as a first-line screening tool for diagnosis of H pylori infection in untreated patients.