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

https://doi.org/10.1136/ebm.6.6.189

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    (2001) BMJ 322, 898. Delaney BC, Wilson S, Roalfe A, et al.. Randomised controlled trial of Helicobacter pylori testing and endoscopy for dyspepsia in primary care.. Apr 14;. :. –901.
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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?

    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 …

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    Footnotes

    • 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.