Description of Medical ServiceThe 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 ConditionGORD 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 NumberNot Applicable
PICO ConfirmationFinal Decision Analytic Protocol (DAP) (PDF 214 KB)
Final Decision Analytic Protocol (DAP) (Word 151 KB)
Assessment ReportContracted Assessment Report (PDF 2059 KB)
Contracted Assessment Report (Word 1574 KB)
Public Summary DocumentPublic Summary Document (PDF 119 KB)
Public Summary Document (Word 142 KB)
Meetings for this Application
PASC12 – 13 April 2012
16 – 17 August 2012