Trial reportBMJ (Clinical research ed.)2008
Helicobacter pylori test and treat versus proton pump inhibitor in initial management of dyspepsia in primary care: multicentre randomised controlled trial (MRC-CUBE trial).
Trial report in BMJ (Clinical research ed.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 7 of them syntheses that pooled 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.
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.
Who cites it
31 citing papers in PubMed, 7 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- First regional consensus on the management ofWorld journal of gastroenterology · 2025Guideline
- Effectiveness of management strategies for uninvestigated dyspepsia: systematic review and network meta-analysis.BMJ (Clinical research ed.) · 2019Pooled it
- Proton pump inhibitors for functional dyspepsia.The Cochrane database of systematic reviews · 2017Pooled it
- ACG and CAG Clinical Guideline: Management of Dyspepsia.The American journal of gastroenterology · 2017Guideline
- Proton pump inhibitors for functional dyspepsia.The Cochrane database of systematic reviews · 2017Pooled it
- Development of an online library of patient-reported outcome measures in gastroenterology: the GI-PRO database.The American journal of gastroenterology · 2014Pooled it
- [Clinical practice guideline on the management of patients with dyspepsia. Update 2012].Atencion primaria · 2012Guideline
- Trial
- VTH BRAZILIAN CONSENSUS CONFERENCE ON HELICOBACTER PYLORI INFECTION.Arquivos de gastroenterologia · 2026Article
- A survey of practice patterns and adherence to national and international guidelines on the management of Helicobacter pylori infection among gastroenterologists and gastroenterology fellows in India.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2025Article
- Cost-effectiveness of adding aEnvironmental and occupational health practice · 2023Article
- Prevention of overuse: A view on upper gastrointestinal endoscopy.World journal of gastroenterology · 2019Review
- Clinical measurement of gastrointestinal motility and function: who, when and which test?Nature reviews. Gastroenterology & hepatology · 2018Review
- Point-of-careThe British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Handling Missing Data in Within-Trial Cost-Effectiveness Analysis: A Review with Future Recommendations.PharmacoEconomics - open · 2017Review
- A multicenter randomized trial comparing rabeprazole and itopride in patients with functional dyspepsia in Japan: the NAGOYA study.Journal of clinical biochemistry and nutrition · 2017Article
- Test-treatment RCTs are susceptible to bias: a review of the methodological quality of randomized trials that evaluate diagnostic tests.BMC medical research methodology · 2017Review
- Economic evaluation of test-and-treat and empirical treatment strategies in the eradication of Helicobacter pylori infection; A Markov model in an Iranian adult population.Medical journal of the Islamic Republic of Iran · 2016Article
- Detection of genotypic clarithromycin-resistant Helicobacter pylori by string tests.World journal of gastroenterology · 2014Article
- Helicobacter Pylori "Test-and-Treat" Strategy for Management of Dyspepsia: A Comprehensive Review.Clinical and translational gastroenterology · 2013Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
objectiveTo determine the cost effectiveness of Helicobacter pylori "test and treat" compared with empirical acid suppression in the initial management of patients with dyspepsia in primary care.
designRandomised controlled trial.
setting80 general practices in the United Kingdom.
participants699 patients aged 18-65 who presented to their general practitioner with epigastric pain, heartburn, or both without "alarm symptoms" for malignancy.
interventionH pylori 13C urea breath test plus one week of eradication treatment if positive or proton pump inhibitor alone; subsequent management at general practitioner's discretion.
main outcome measuresCost effectiveness in cost per quality adjusted life year (QALY) (EQ-5D) and effect on dyspeptic symptoms at one year measured with short form Leeds dyspepsia questionnaire.
results343 patients were randomised to testing for H pylori, and 100 were positive. The successful eradication rate was 78%. 356 patients received proton pump inhibitor for 28 days. At 12 months no significant differences existed between the two groups in QALYs, costs, or dyspeptic symptoms. Minor reductions in costly resource use over the year in the test and treat group "paid back" the initial cost of the intervention.
conclusionsTest and treat and acid suppression are equally cost effective in the initial management of dyspepsia. Empirical acid suppression is an appropriate initial strategy. As costs are similar overall, general practitioners should discuss with patients at which point to consider H pylori testing.
trial registrationCurrent Controlled Trials ISRCTN87644265.
Indexed as
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What Socratic holds
Registered trials
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.