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

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 QUESTION: In patients who had had dyspepsia for > 4 weeks, are testing and endoscopy as cost-effective as usual management for dyspepsia?


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


31 primary care centres in the UK.


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.


Patients were allocated to testing (Helisal test), and endoscopy (n=285) or usual management (n=193). Endoscopies on patients with positive …

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  • Sources of funding: National Health Services; The Astra Foundation supplied the Helisal tests.

  • For correspondence: Dr B C Delaney, University of Birmingham Medical School, Department of General Practice, Vincent Drive, Edgbaston, Birmingham, BI5 2TT, UK. Fax +44 (0) 121 414 6571.

  • * See glossary.