1203 - Catheter-free ambulatory pH test for gastroesophageal reflux disease (GORD)

Page last updated: 11 October 2016

Application Detail



Description of Medical Service

The Bravo pH Monitoring System is a catheter-free ambulatory pH test for gastroesophageal reflux disease (GORD). The Bravo pH Monitoring System utilizes a small pH capsule that is temporarily attached to the wall of the esophagus to transmit pH data for a minimum of 48 hours.

Description of Medical Condition

GORD occurs when reflux exposes the patient to the risk of physical complications or symptoms that would lead to a significant impairment of wellbeing or quality of life. Clinically significant impairment of wellbeing usually occurs when symptoms are present on two or more days of the week. Reflux carries the risk of reflux (peptic) esophagitis and complications such as Barrett esophagus and esophageal adenocarcinoma.

Reason for Application


Medical Service Type


Previous Application Number

Not Applicable

Associated Documentation

Application Form


PICO Confirmation

Final Decision Analytic Protocol (DAP) (PDF 214 KB)
Final Decision Analytic Protocol (DAP) (Word 151 KB)

Assessment Report

Contracted Assessment Report (PDF 2059 KB)
Contracted Assessment Report (Word 1574 KB)

Public Summary Document

Public Summary Document (PDF 119 KB)
Public Summary Document (Word 142 KB)

Meetings for this Application


12 – 13 April 2012
16 – 17 August 2012


13 – 14 February 2014


3 - 4 April 2014