Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a guideline (underpinned by a systematic review) that focuses on the above important clinical question.
Confidence in the evidence is high or moderate to high where GRADE has been performed and the intervention is more effective/beneficial than the comparison for key outcomes.
Population: People with undiagnosed dyspepsia
Intervention: H Pylori test and treat
Comparison: Early endoscopy
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Dyspepsia outcome (follow up: median 1 years; assessed with questionnaire) | No statistically significant difference | Moderate |
Proportion having upper gastrointestinal (GI) endoscopy over a 1 year period | Favours Intervention ᵃ | GRADE assessment not performed for this outcome |
Health-related dyspepsia costs (US $) (follow up: median 1 years; assessed with questionnaire) | Favours Intervention ᵃ | High |
Recommendations as stated in the source guideline The American College of Gastroenterology and the Canadian Association of Gastroenterology 2017 guideline on the Management of Dyspepsia makes the following recommendation: We recommend dyspepsia patients under the age of 60 should have a non-invasive test for H Pylori, and therapy for H pylori infection if positive (strong recommendation, high-quality evidence).
Note The guideline recommends that all people with uninvestigated dyspepsia who are aged 60 or over have an endoscopy to exclude upper gastrointestinal neoplasia. ᵃ The guideline group noted that 25% of participants in the H Pylori test and treat group underwent an upper GI endoscopy over a 12-month period compared with almost all participants in the early endoscopy group. This was the main reason for the statistically significant cost-saving in the H Pylori test and treat group.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
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