EDITOR—The papers by Chiba et al and McColl et al show that in the medium term a test and treat approach in dyspepsia can be as effective or better than endoscopically led management. 1 2 However, an individualised approach remains prudent in primary care.

In the long version of the paper by Chiba et al on bmj.com (bmj.com/cgi/content/full/324/7344/1012), 33% of people with a positive result to the initial near patient test were negative on breath testing. Such results are important in …