H pylori testing and endoscopy for dyspepsia in primary care

doi:10.1136/bmj.323.7308.342

BMJ 2001;323:342 ( 11 August )

Letters

H pylori testing and endoscopy for dyspepsia in primary care

Improved diagnostic accuracy is important in dyspepsia

Authors' reply

Test and treat seems best

Improved diagnostic accuracy is important in dyspepsia

The first 150 words of the full text of this article appear below.

EDITOR $---$ Delaney et al's trial of Helicobacter pylori testing and endoscopy for dyspepsia in primary care surely misses thepoint of medical consultations for dyspepsia.¹ Most doctorswould view the purpose of a consultation as primarily to makea diagnosis before starting treatment. If the purpose is to initiateempirical prescribing $---$ these authors seem to advocate this as theyconclude that this "is . . . the best treatment" $---$ the patientsmight as well go to a pharmacist and treatthemselves.

This study is flawed. It uses a screening test for H pylori (Helisal) that has been reported to have sensitivities of only67-88%, with a specificity of 78-91%. ² ³ The test is thereforenot an accurate means of detecting H pylori, which presumablyexplains why so many ulcers were found in the control patientswho were H pylori negative (four out of 48 endoscopies carriedout).

Conclusions have been drawn on symptomatic . . . [Full text of this article]

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Articles

Randomised controlled trial of Helicobacter pylori testing and endoscopy for dyspepsia in primary care: B C Delaney, S Wilson, A Roalfe, L Roberts, V Redman, A Wearn, and F D R Hobbs
BMJ 2001 322: 898. [Abstract] [Full Text] [PDF]

Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia: Paul Moayyedi, Shelly Soo, Jonathan Deeks, David Forman, James Mason, Michael Innes, and Brendan Delaney
BMJ 2000 321: 659-664. [Abstract] [Full Text] [PDF]