TY - JOUR T1 - <span hwp:id="article-title-1" class="article-title">Step-up and step-down treatment strategies did not differ for symptom relief at 6 months in new onset dyspepsia</span><span hwp:id="article-title-2" class="sub-article-title">Commentary</span> JF - Evidence Based Medicine JO - Evid Based Med SP - 114 LP - 114 DO - 10.1136/ebm.14.4.114 VL - 14 IS - 4 AU - Nicholas J Talley Y1 - 2009/08/01 UR - http://ebm.bmj.com/content/14/4/114.abstract N2 - Design:randomised controlled trial (Dutch study on Initial Management Of Newly diagnosed Dyspepsia [DIAMOND]). ClinicalTrials.gov NCT00247715.Allocation:concealed.*Blinding:blinded (patients, {investigators, and study personnel}†).*Setting:312 primary care physician practices in the Netherlands.Patients:664 patients ⩾18 years of age (54% women) who visited their general practitioner for new onset dyspepsia (pain or discomfort in upper abdomen and originating in upper gastrointestinal tract). Exclusion criteria included gastroscopy in the past year, use of prescribed acid suppressive medication in the past 3 months, alarm symptoms (dysphagia, weight loss, anaemia, or haematemesis), pregnancy, or insufficient knowledge of Dutch.Intervention:step-up treatment (n = 341) given in 3 four-week steps: (1) antacid (aluminium oxide, 200 mg/magnesium hydroxide, 400 mg) 4 times/day, … ER -