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

摘要: BACKGROUND: The first step in the management of uncomplicated dyspepsia primary care often consists prescribing empirical therapy, but certain cases prompt endoscopy might be preferred. Any decision is usually based on patient9s symptoms and presumed underlying pathology that causes these symptoms. AIM: To assess relationship between symptom subgroups effect strategies patients with dyspepsia. DESIGN OF STUDY: Randomised controlled trial. SETTING: All presenting successively a new episode January 1995 November 1997. METHOD: results four dyspeptic were compared value subgrouping within this trial was estimated. Patients allocated to one either (a) treatment which therapy presented symptoms, or (b) omeprazole (c) cisapride regardless (d) followed by appropriate treatment. retrospectively classified into for each strategy using baseline data. yield measured counting number failures year. RESULTS: Of 349 included patients, 326 analysed. No statistically significant difference could demonstrated subgroups. However, reflux-like subgroup showed trend towards better outcome all strategies. Ulcer-like seemed benefit from omeprazole. non-specific also had highest proportion failure. Prompt did not appear especially useful any subgroup. CONCLUSION: Although study has relatively low power, we conclude use seems sensible approach when choosing seem have best prognosis year every strategy.