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Helicobactor pylori testing and endoscopy were less cost-effective than usual management for patients with dyspepsia

Design
Cost-effectiveness analysis from a health service perspective of a randomised (allocation concealed*), unblinded,* controlled trial with 18 months of follow up.

Setting
31 primary care centres in the UK.

Patients
478 patients (mean age 37 y, 57% men) who had had dyspepsia (epigastric pain or heartburn with or without nausea and bloating) for > 4 weeks. Exclusion criteria included patients who had had endoscopy or a positive result on barium meal examination in the previous 3 years or were unable to give informed consent. 99% of patients completed the trial.

Intervention
Patients were allocated to testing (Helisal test), and endoscopy (n=285) or usual management (n=193). Endoscopies on patients with positive results on the Helisal test were done according to usual practice at open access services at 6 local hospitals. Patients with negative results received empirical acid-suppressing drugs. Patients in the control group received the usual management strategy used by their . . . [Full text of this article]

Nicholas J Talley, MD, PHD

University of Sydney Penrith, Australia