Trial reportBMJ (Clinical research ed.)2003
Empirical prescribing for dyspepsia: randomised controlled trial of test and treat versus omeprazole treatment.
Trial report in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Effectiveness of management strategies for uninvestigated dyspepsia: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- ACG and CAG Clinical Guideline: Management of Dyspepsia.The American journal of gastroenterology · 2017Guideline
- [Clinical practice guideline on the management of patients with dyspepsia. Update 2012].Atencion primaria · 2012Guideline
- Helicobacter pylori test and treat versus proton pump inhibitor in initial management of dyspepsia in primary care: multicentre randomised controlled trial (MRC-CUBE trial).BMJ (Clinical research ed.) · 2008Trial
- Trial
- Review article: the global emergence of Helicobacter pylori antibiotic resistance.Alimentary pharmacology & therapeutics · 2016Review
- Helicobacter pylori and functional dyspepsia: an unsolved issue?World journal of gastroenterology · 2014Review
- Helicobacter Pylori "Test-and-Treat" Strategy for Management of Dyspepsia: A Comprehensive Review.Clinical and translational gastroenterology · 2013Article
- Evaluation and management of dyspepsia.Therapeutic advances in gastroenterology · 2010Article
- Clinical practice: diagnosis and evaluation of dyspepsia.Journal of clinical gastroenterology · 2010Review
- NSAIDs and the gastrointestinal tract.Current gastroenterology reports · 2009Article
- Dyspepsia results may not apply in primary care.BMJ (Clinical research ed.) · 2003Article
Corrections and comments
- Commented on by
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the efficacy of a "Helicobacter pylori test and treat" strategy with that of an empirical trial of omeprazole in the non-endoscopic management by empirical prescribing of young patients with dyspepsia.
designRandomised controlled trial.
settingHospital gastroenterology unit.
participants219 patients under 45 years old presenting with dyspepsia without alarm symptoms.
interventionPatients received treatment with omeprazole 20 mg (group A) or with a urea breath test followed by an eradication treatment in case of H pylori infection or omeprazole alone in non-infected patients (group B). Lack of improvement or recurrence of symptoms prompted endoscopy.
main outcome measuresImprovement in symptoms assessed by a dyspepsia severity score every two months; use of medical resources (endoscopic workload and medical consultation); clinical outcome.
results96/109 (88%) patients in group A and 61/110 (55%) in group B (P < 0.0001) had endoscopy: in 19 patients in group A and 32 in group B (20/67 infected and 12/43 non-infected) because of no improvement; in 77 further patients in group A and 29 in group B (7 infected and 22 non-infected) because of recurrence of symptoms during follow up. Endoscopy showed peptic ulcers only in group A; oesophagitis occurred significantly more often in group B than in group A. About 80% of examinations were normal in both groups, but nine duodenal scars occurred in group A.
conclusionsEradication treatment allows resolution of symptoms in a large number of patients with dyspepsia and reduces the endoscopic workload. After a trial of omeprazole, symptoms recur in nearly every patient. Such treatment is also likely to mask an appreciable number of peptic ulcers and cases of oesophagitis.
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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.