What remaining questions regarding Helicobacter pylori and associated diseases should be addressed by future research ? View from North America.
American Digestive Health Foundation International Update Conference on Helicobacter pylori. McLean, VA, USA, 1997/02/13.
Several areas regarding Helicobacter pylori that need improvement or clarification in the United States include treatment of dyspepsia, physician education on disease associations with H. pylori, and evidence from U.S. studies that 7-day H. pylori eradication regimens are more effective than current regimens.
Dyspepsia, a ubiquitous condition in the United States, is routinely managed on the basis of a positive H. pylori serology without other investigations.
This approach has been fostered by cost-effectiveness studies of various approaches to duodenal ulcer and dyspeptic patients.
Serology-directed therapy was the most cost-effective option vs. endoscopy-directed management.
The option of not obtaining endoscopy had broad appeal to primary care physicians.
In addition, a recent survey suggests that even gastroenterologists routinely attempt H. pylori eradication in infected patients with nonulcer dyspepsia, despite a number of negative efficacy studies.
Finally, the option of not eradicating a World Health Organization-defined carcinogen in the litigious United States is unappealing to clinicians.
Eradication of H. pylori in patients with dyspepsia despite more negative trials is likely to continue.
There is evidence that U.S. physician awareness of the H. pylori-disease associations and the best therapies are improving rapidly, but further improvement is needed.
Discrepancy of awareness of H. pylori between gastroenterologists and family physicians exists. (...)
Mots-clés Pascal : Gastrite, Campylobactériose, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Dyspepsie, Association morbide, Traitement, Evaluation performance, Dépistage, Analyse avantage coût, Formation professionnelle, Etude critique, Homme, Appareil digestif pathologie, Estomac pathologie, Economie santé
Mots-clés Pascal anglais : Gastritis, Campylobacter infection, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Dyspepsia, Concomitant disease, Treatment, Performance evaluation, Medical screening, Cost benefit analysis, Occupational training, Critical study, Human, Digestive diseases, Gastric disease, Health economy
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0093926
Code Inist : 002B05B02F. Création : 14/05/1998.