Evidence map›Paper›PMID 11510389›Full record

Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2001

A randomised controlled trial of four management strategies for dyspepsia: relationships between symptom subgroups and strategy outcome.

N T Lewin van den Broek, M E Numans, E Buskens, T J Verheij, N J de Wit, A J Smout

Open access · greenAbstract readClinical TrialRandomized Controlled Trial
PubMed Full text at PMC
In one paragraph

Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 5 pooled it
4.0field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 5 syntheses or guidelines pooled it, 57 citations in OpenAlex.

  1. Pooled it
  2. Proton pump inhibitors for functional dyspepsia.The Cochrane database of systematic reviews · 2017
    Pooled it
  3. ACG and CAG Clinical Guideline: Management of Dyspepsia.The American journal of gastroenterology · 2017
    Guideline
  4. Proton pump inhibitors for functional dyspepsia.The Cochrane database of systematic reviews · 2017
    Pooled it
  5. Pooled it
  6. Clinical practice: diagnosis and evaluation of dyspepsia.Journal of clinical gastroenterology · 2010
    Review
  7. Managing dyspepsia.Current gastroenterology reports · 2009
    Review
  8. Review
  9. Managing dyspepsia in a primary care setting.Clinical medicine & research · 2006
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

N T Lewin van den BroekJulius Centre for General Practice and Patient Oriented Research, University Medical Centre, Stratenum 6.107, PO Box 85060, 3508 AB Utrecht, The Netherlands.
M E Numans
E Buskens
T J Verheij
N J de Wit
A J Smout
University Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe first step in the management of uncomplicated dyspepsia in primary care often consists of prescribing empirical therapy, but in certain cases prompt endoscopy might be preferred. Any decision is usually based on the patient's symptoms and the presumed underlying pathology that causes these symptoms.

aimTo assess the relationship between symptom subgroups and the effect of management strategies on primary care patients with dyspepsia. DESIGN OF STUDY: Randomised controlled trial.

settingAll patients presenting successively with a new episode of dyspepsia between January 1995 and November 1997.

methodThe results of four management strategies in dyspeptic primary care patients were compared and the value of subgrouping within this trial was estimated. Patients were allocated to one of either (a) empirical treatment in which therapy was based on the presented symptoms, or empirical treatment with (b) omeprazole or (c) cisapride regardless of the presented symptoms, or (d) prompt endoscopy followed by the appropriate treatment. Patients were retrospectively classified into the subgroups for each strategy using baseline data. The yield of each strategy was measured by counting the number of strategy failures in the first year.

resultsOf the 349 included patients, 326 were analysed. No statistically significant difference could be demonstrated between the strategies or between the symptom subgroups. However, patients in the reflux-like subgroup showed a trend towards a better outcome in all empirical strategies. Ulcer-like dyspepsia seemed to benefit from omeprazole. The non-specific subgroup seemed to benefit from cisapride but also had the highest proportion of strategy failure. Prompt endoscopy did not appear especially useful in any subgroup.

conclusionAlthough this study has relatively low power, we conclude that the use of symptom subgroups seems to be a sensible approach when choosing empirical therapy in dyspepsia. Patients with reflux-like symptoms seem to have the best prognosis in the first year in every strategy.

Indexed as

Anti-Ulcer AgentsCimetidineCisaprideClinical ProtocolsDyspepsiaEndoscopy, GastrointestinalFamily PracticeFemaleHumansMaleOdds RatioOmeprazolePractice Guidelines as TopicRanitidineRetrospective StudiesTreatment OutcomeAnti-Ulcer AgentsCimetidineCisaprideOmeprazoleRanitidine

Identifiers

PMID11510389
PMCPMC1314070
OpenAlexW1532872569

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.