Detection of gastric erosions: comparison of biphasic radiography with fiberoptic endoscopy.

Shaw, P C; Romunde, L K van; Griffioen, G.; Janssens, A. R.; Kreuning, J; Lamers, C. B. H. W.

doi:10.1148/radiology.178.1.1984327

Cited by 20 publications

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“…An important reason for patients with dyspeptic symptoms to consult a physician is fear of having a malignancy. Negative upper gastrointestinal endoscopy results can appease these fears, but there are other methods to reassure patients, such as upper gastrointestinal radiology, because the diagnostic yield of radiology is comparable with endoscopy for upper gastrointestinal malignancies 26 . The only disadvantage is that, if a suspicious lesion is detected, the patient should be referred for upper gastrointestinal endoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Negative upper gastrointestinal endoscopy results can appease these fears, but there are other methods to reassure patients, such as upper gastrointestinal radiology, because the diagnostic yield of radiology is comparable with endoscopy for upper gastrointestinal malignancies. 26 The only disadvantage is that, if a suspicious lesion is detected, the patient should be referred for upper gastrointestinal endoscopy. However, previous studies have indicated that gastrointestinal malignancies are only found in a minority of patients (< 5%) who the general practitioner refers a need for endoscopy or radiology.…”

Section: Discussionmentioning

confidence: 99%

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Randomized controlled trial of omeprazole or endoscopy in patients with persistent dyspepsia: a cost‐effectiveness analysis

Laheij

Severens

Lisdonk

et al. 1998

Aliment Pharmacol Ther

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INTRODUCTIONOpen access to endoscopy facilities for general practitioners has resulted in increased endoscopic workload and an increase in hospital costs.1 Consequently, it is now under discussion whether the service should only be targeted at a selected group of patients who genuinely need endoscopy.2 Several studies have investigated whether empirical treatment instead of prompt endoscopy could increase appropriate use of endoscopy facilities and decrease costs. 3±7 Regrettably, most of the data are based on decision analysis 3±5 and, to our knowledge, only one randomized clinical trial 6 and one cohort study 7 have prospectively compared an empirical treatment strategy to prompt endoscopy in patients with dyspeptic symptoms. The randomized clinical trial demonstrated that empirical treatment was associated with higher costs and lower patient satisfaction, whereas in the cohort study, an empirical treatment strategy was cheaper and achieved comparable clinical results to the conventional strategy. A pitfall in both studies was that empirical treatment was given with either an H 2 -receptor antagonist (ranitidine) or prokinetics and not with proton pump inhibitors, the latter being the most effective acidsuppressing drugs available. 8,9 Thus in acid-related SUMMARY Background: Cost-effectiveness analysis, Helicobacter pylori research and the development of proton pump inhibitors are having an increasing impact on the management of dyspepsia. However, clinical trials have not always included both H. pylori diagnosis and proton pump inhibitors in their protocols. Methods: Patients who were referred for upper gastrointestinal endoscopy by their general practitioner were randomized to either prompt endoscopy followed by directed medical treatment (conventional group, n 38), or to empirical treatment with omeprazole and, in the case of symptom relapse, serological screening for H. pylori infection followed by eradication therapy in seropositive patients (empirical group, n 42). The study lasted for up to 1 year.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of omeprazole or endoscopy in patients with persistent dyspepsia: a cost‐effectiveness analysis

Laheij

Severens

Lisdonk

et al. 1998

Aliment Pharmacol Ther

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Guía de práctica clínica sobre el manejo del paciente con dispepsia. Actualización 2012

et al. 2012

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The aim of the Clinical Practice Guideline (CPG) on the Management of Patients with Dyspepsia is to generate recommendations on the optimal approach to dyspepsia in the primary care and specialized outpatient setting. The main objective of this CPG is to help to optimize the diagnostic process, identifying patients with a low risk of a serious organic disease (mainly tumoral), who could be safely managed without the need for invasive diagnostic tests and/or referral to a specialist. The importance of this aim lies in the need to accurately diagnose patients with esophagogastric cancer and correctly treat peptic ulcer while, at the same time, reduce negative endoscopies in order to appropriately use the available healthcare resources. This CPG reviews the initial strategies that can be used in patients with uninvestigated dyspepsia and evaluates the possible decision to begin empirical therapy or to investigate the existence of a lesion that could explain the symptoms. This CPG also discusses functional dyspepsia, which encompasses all patients with dyspepsia with no demonstrable cause on endoscopy. Recommendations for the diagnosis and treatment of peptic ulcer and Helicobacter pylori infection are also made. To classify the scientific evidence and strengthen the recommendations, the GRADE (Grading of Recommendations Assessment, Development and Evaluation Working Group) system has been used (http://www.gradeworkinggroup.org/).

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Guía de práctica clínica sobre el manejo del paciente con dispepsia. Actualización 2012

Gisbert

Ferrándiz

Mascort

et al. 2012

Gastroenterología y Hepatología

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Detection of gastric erosions: comparison of biphasic radiography with fiberoptic endoscopy.

Cited by 20 publications

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Randomized controlled trial of omeprazole or endoscopy in patients with persistent dyspepsia: a cost‐effectiveness analysis

Randomized controlled trial of omeprazole or endoscopy in patients with persistent dyspepsia: a cost‐effectiveness analysis

Guía de práctica clínica sobre el manejo del paciente con dispepsia. Actualización 2012

Guía de práctica clínica sobre el manejo del paciente con dispepsia. Actualización 2012

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