We read with interest the paper by Mera and colleagues (Gut 2005;54:1536–40) on the effect of eradicating Helicobacter pylori infection on precancerous gastric lesions. However, we have concern regarding the extent to which the limited data provided in the paper support the authors’ conclusions of regression of atrophy and intestinal metaplasia following H pylori eradication.

The main outcome reported was the average histological score. This is an arbitrary ordinal scale which is based on the presence of superficial gastritis, atrophic gastritis, intestinal metaplasia, dysplasia, or cancer as the most advanced …