Abstract：
BACKGROUND:Unable to resolve a medical problem, gastroenterologists occasionally choose an ineffectual intervention instead. The elusive path to effectual management becomes substituted with an ineffectual but readily available medical ritual. The term 'ritual' refers to the utilization of an ineffectual intervention with little chances of achieving a medically relevant goal. AIM:The aim of the article is to analyse the cost-benefit relationship of rituals in gastroenterology and the reasons why gastroenterologists utilize them. METHODS:Ritualistic disease management is described in terms of medical decision and threshold analysis. RESULTS:If the perceived benefit of a ritual exceeds its cost, the ineffectual path becomes more attractive than expectant management or doing nothing. To engage in an ineffectual intervention, the threshold probability for success needs to exceed its cost-benefit difference divided by the benefit associated with success. In choosing an ineffectual intervention, doctors tend to underestimate the true costs of a ritual and overestimate its probability of success. The availability of an effectual path leads to more stringent conditions for the benefit associated with an ineffectual path. CONCLUSIONS:A better understanding of their economical underpinnings should lead to more restricted utilization of rituals in gastroenterology, especially, in situations where they drain scarce resources disproportionately to their perceived benefit.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Sonnenberg Adoi
10.1111/j.1365-2036.2004.02252.xsubject
Has Abstractpub_date
2004-11-01 00:00:00pages
939-42issue
9eissn
0269-2813issn
1365-2036pii
APT2252journal_volume
20pub_type
杂志文章abstract：BACKGROUND:The long-term time trends of multiple gastrointestinal diseases are characterised by a striking rise and fall. These temporal changes provide important clues about disease aetiology. AIM:To highlight the importance of Helicobacter pylori infection in shaping the temporal trends of many common gastrointestin...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 历史文章,杂志文章,评审
doi：10.1111/apt.12380
更新日期：2013-08-01 00:00:00
abstract：BACKGROUND:The efficacy of interferon-alpha plus ribavirin treatment for patients not responding to interferon monotherapy is not well established. AIM:To assess the efficacy and safety of combination therapy with interferon-alpha 2a/2b plus ribavirin by performing a meta-analysis of randomized clinical trials. METHO...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,meta分析,评审
doi：10.1046/j.1365-2036.2002.01328.x
更新日期：2002-09-01 00:00:00
abstract：BACKGROUND:A large proportion (25-46%) of adults with inflammatory bowel disease in remission has symptoms of irritable bowel syndrome (IBS), which are thought to reflect ongoing inflammation. Data on paediatric inflammatory bowel disease patients are lacking. AIM:To investigate (i) the prevalence of IBS-type symptoms...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.13636
更新日期：2016-07-01 00:00:00
abstract：BACKGROUND:The effects of lactulose and polyethylene glycol on colonic transit are poorly established. AIM:To assess the effects of these laxatives on colonic transit in normal subjects. METHODS:Colonic transit (mean residence time, cumulative counts in stool, counts remaining in the proximal or distal colon) was mea...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 临床试验,杂志文章
doi：10.1111/j.1365-2036.2005.02244.x
更新日期：2005-02-01 00:00:00
abstract：BACKGROUND:Obesity is associated with non-alcoholic fatty liver disease (NAFLD), and the patatin-like phospholipase 3 (PNPLA3) rs738409 (Ile148Met, C>G) gene polymorphism is one of the most important genetic determinants of NAFLD. Carriers have been reported to better respond to lifestyle modification. AIM:To investig...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.13232
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND:Helicobacter pylori eradication is a challenge in patients allergic to penicillin, especially those who have failed a first-eradication trial. AIM:To assess the efficacy and tolerability of H. pylori first-line treatment and rescue options in patients allergic to penicillin. METHODS:Prospective single cent...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/j.1365-2036.2005.02687.x
更新日期：2005-11-15 00:00:00
abstract：BACKGROUND:Real-world data quantifying the costs of increasing use of biologics in inflammatory bowel disease (IBD) are unknown. AIM:To determine the outpatient IBD drug utilization trends, relative market share, and costs in the USA during a 9-year period. METHODS:The Truven MarketScan® Database was analysed for pat...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.14430
更新日期：2018-02-01 00:00:00
abstract：:The Consensus Conference on Hepatorenal Syndrome (HRS) organized by the International Ascites Club in 1994 redefined HRS, introduced new diagnostic criteria that are now widely accepted, and proposed the distinction between two types of HRS: type 1 and type 2. Before the introduction of the new therapeutic options, th...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,评审
doi：10.1111/j.1365-2036.2004.02113.x
更新日期：2004-09-01 00:00:00
abstract：AIM:To assess the pathophysiology and treatment of neurogenic dysphagia. METHODS:46 patients with brain damage, 46 with neurodegenerative diseases and eight healthy volunteers were studied by videofluoroscopy while swallowing 3-20 mL liquid (20.4 mPa s), nectar (274.4 mPa s) and pudding (3931.2 mPa s) boluses. RESULT...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/j.1365-2036.2006.03118.x
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:Antibiotic resistance and duration of therapy influence the success of proton-pump inhibitor-containing Helicobacter pylori eradication therapy. Clarithromycin resistance is associated with treatment failure. AIM:To examine the success of a 7-day rabeprazole-clarithromycin-amoxicillin therapy in the study p...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/j.1365-2036.2006.02755.x
更新日期：2006-01-15 00:00:00
abstract：BACKGROUND:It is not clear which dose of clarithromycin (500 mg b.d. or 250 mg b.d.) is more effective for Helicobacter pylori eradication in proton pump inhibitor-based triple therapies. METHODS:We undertook a meta-analysis of the effect of 7-day triple therapies consisting of a proton pump inhibitor (P), and clarith...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,meta分析
doi：10.1046/j.1365-2036.1999.00530.x
更新日期：1999-06-01 00:00:00
abstract：BACKGROUND:Bovine colostrum is a rich source of nutrients, antibodies and growth factors. AIM:To examine the efficacy of colostrum enemas in the treatment of distal colitis using a randomized, double-blind, controlled protocol. METHODS:Fourteen patients (eight female), with a mean age of 45 years (range, 16-75 years)...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1046/j.1365-2036.2002.01354.x
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is associated with colorectal neoplasia. Yet, NAFLD ranges from simple steatosis to steatohepatitis with advanced fibrosis. AIM:To investigate the risk of colorectal neoplasia according to the presence and severity of NAFLD. METHODS:A total of 26 540 asymptomatic a...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.13866
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is expected to become a leading aetiology of hepatocellular carcinoma (HCC)-related mortality in the United States. HCC treatments with curative intent (OLT, orthotopic liver transplantation; resection; RFA, radiofrequency ablation) can improve survival in carefully ...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.14342
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Proton pump inhibitors (PPIs) are the most commonly used first-line therapy for patients with eosinophilic oesophagitis (EoE). However, many aspects related to PPIs in EoE are still unknown. AIMS:To assess the effectiveness of PPI therapy for EoE in real-world practice. METHODS:This cross-sectional study c...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.15957
更新日期：2020-09-01 00:00:00
abstract：BACKGROUND:A short-term course of pegylated-interferon (Peg-IFN), or a long-term treatment with a third generation nucleot(s)ide analogue (NUC), of chronic hepatitis B (CHB) infection achieves viral suppression and may prevent disease progression. Owing to different mechanisms of action of the two regimens, a Peg-IFN a...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,评审
doi：10.1111/apt.13751
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:Incidence and mortality of gastric cancer (GC) are high in Mongolia despite Helicobacter pylori in the Mongolian population being less virulent. AIM:To evaluate gastric bacterial microbiota profiles in patients with GC and its precursor histological conditions. METHODS:We conducted a case-control study amo...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.15675
更新日期：2020-04-01 00:00:00
abstract：:Variceal bleeding is a consequence of portal hypertension, which in turn is the major complication of hepatic cirrhosis. Given the high rate of mortality of the first bleeding episode, primary prophylaxis to prevent bleeding from varices and portal hypertensive gastropathy is the current optimal therapeutic approach. ...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,评审
doi：10.1046/j.1365-2036.2000.00778.x
更新日期：2000-07-01 00:00:00
abstract：BACKGROUND:Combination treatment with azathioprine for 6-12 months is the preferred strategy for starting infliximab due to improved pharmacokinetics. However, optimised infliximab monotherapy with proactive dose escalations in case of low trough levels is a safer but under-studied alternative. AIM:To compare the clin...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.15179
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Inflammatory bowel disease (IBD) is characterised by intense mucosal recruitment of activated leukocytes. Chemokines determine inflammatory leukocyte recruitment and retention. AIM:To compare expression of the entire chemokine family within colonic mucosa from IBD patients and uninflamed controls. METHODS:...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/j.1365-2036.2004.02262.x
更新日期：2005-01-15 00:00:00
abstract：BACKGROUND:Drug development in hepatocellular carcinoma (HCC) is limited by disease heterogeneity, with hepatic reserve being a major source of variation in survival outcomes. The albumin-bilirubin (ALBI) grade is a validated index of liver function in patients with HCC. AIM:To test the accuracy of the ALBI grade in p...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,多中心研究
doi：10.1111/apt.13904
更新日期：2017-03-01 00:00:00
abstract：BACKGROUND:Crohn's disease (CD) has a high-risk of bowel resection and later surgery for recurrent disease. Recent guidelines recommend colonoscopy 6-12 months following surgery to reduce further surgical intervention through medical therapy intensification. AIMS:To investigate the risk of further surgery at the anast...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.16114
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Treatment options for non-alcoholic steatohepatitis (NASH) are limited. Weight loss remains the most recommended therapy. Orlistat is an effective adjunct to dietary weight loss therapy. AIM:To evaluate the efficacy of orlistat, given for 6 months to patients with obesity and biopsy confirmed NASH. METHODS...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1365-2036.2004.02153.x
更新日期：2004-09-15 00:00:00
abstract：BACKGROUND:Both simple proportions and statistical tests are utilised for symptom-reflux association. We systematically compared three such tests in a clinical setting. AIM:To compare the three commonly used symptom reflux association tests in a large cohort of patients undergoing ambulatory pH monitoring for the eval...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/j.1365-2036.2012.05066.x
更新日期：2012-05-01 00:00:00
abstract：BACKGROUND:Although short-term outcome in severe alcoholic hepatitis (SAH) is well described, its long-term course remains uncharacterised. AIM:To assess determinants of long-term outcome in SAH. METHODS:Data were recorded from a cohort with SAH (admission Discriminant Function (DF) ≥32). Kaplan-Meier (KM) and Cox pr...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.12427
更新日期：2013-09-01 00:00:00
abstract：BACKGROUND:There are few published data concerning the economic impact of antibiotic prophylaxis prior to endoscopic retrograde cholangiopancreatography in the setting of biliary obstruction. AIM:To perform decision analysis to determine the costs of prophylaxis in patients undergoing endoscopic retrograde cholangiopa...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1046/j.1365-2036.2002.01209.x
更新日期：2002-04-01 00:00:00
abstract：BACKGROUND:The various components of pain and quality of life in duodenal ulcer patients receiving antisecretory drugs have not been studied to date. METHODS:Ninety-five patients with epigastric pain and duodenal ulcer at endoscopy completed this prospective, multicenter, open-study. All were treated with effervescent...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1111/j.1365-2036.1995.tb00402.x
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:Drug toxicity is a well-known cause of acute pancreatitis (AP). Although many drugs have been associated with AP, the magnitude of the risk of most of them remains largely unknown. AIM:To determine the pancreatotoxic risk of a wide range of drugs. METHODS:The hospital-based Berlin case-control surveillance...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章
doi：10.1111/apt.12461
更新日期：2013-10-01 00:00:00
abstract：BACKGROUND:The most common complication after ileal pouch anal anastomosis in up to 50% of patients is an acute pouchitis. The majority of patients respond to antibiotic treatment. However, 10%-15% develops chronic antibiotic-dependent or refractory pouchitis which is usually hard to treat. AIM:To evaluate the effecti...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 杂志文章,多中心研究
doi：10.1111/apt.14479
更新日期：2018-03-01 00:00:00
abstract：AIM:To compare lansoprazole 30 mg daily with ranitidine 150 mg b.d. in the treatment of acid-related dyspepsia in general practice. METHODS:In a double-blind, parallel group, randomized, mutlicentre study conducted in 32 general practices in the UK, 213 patients were randomized to receive lansoprazole 30 mg daily, and...
journal_title：Alimentary pharmacology & therapeutics
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1046/j.1365-2036.1997.00179.x
更新日期：1997-06-01 00:00:00
