Abstract

Decision analysis models have given different conclusions on the value of the Helicobacter pylori “test and treat” strategy for the management of dyspepsia. This uncertainty relates to the lack of primary data on this strategy. Four randomised controlled trials have compared the H pylori “test and treat” strategy with prompt endoscopy and have allowed a more accurate decision analysis model to be constructed. The model indicates that the H pylori test and treat strategy is more cost effective than prompt endoscopy, and should be the new “gold standard” against which other strategies are compared.