Abstract:
OBJECTIVES:To develop an easily applicable diagnostic scoring method to determine the presence of peptic ulcers in dyspeptic patients in a primary care setting; to evaluate whether Helicobacter pylori testing adds value to history taking. DESIGN:Cross sectional study. SETTING:General practitioners' offices in the Utrecht area of the Netherlands. PARTICIPANTS:565 patients consulting a general practitioner about dyspeptic symptoms of at least two weeks' duration. MAIN OUTCOME MEASURES:The presence or absence of peptic ulcer; independent predictors of the presence of peptic ulcer as obtained from history taking and the added value of H pylori testing were quantified by using multivariate logistic regression analyses. RESULTS:A history of peptic ulcer, pain on an empty stomach, and smoking were strong and independent diagnostic determinants of peptic ulcer disease, with odds ratios of 5.5 (95% confidence interval 2.6 to 11.8), 2.8 (1.0 to 4.0), and 2.0 (1.4 to 6.0) respectively. The area under the receiver operating characteristic curve (ROC area) of these determinants together was 0.71. Adding the H pylori test increased the ROC area only to 0.75. However, in a group of patients at high risk, identified by means of a simple scoring rule based on history taking, the predictive value for the presence of peptic ulcer increased from 16% to 26% after a positive H pylori test. CONCLUSIONS:In the total group of dyspeptic patients in primary care, H pylori testing has no value in addition to history taking for diagnosing peptic ulcer disease. In a subgroup of patients at high risk of having peptic ulcer disease, however, it might be useful to test for and treat H pylori infections.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Weijnen CF,Numans ME,de Wit NJ,Smout AJ,Moons KG,Verheij TJ,Hoes AWdoi
10.1136/bmj.323.7304.71keywords:
subject
Has Abstractpub_date
2001-07-14 00:00:00pages
71-5issue
7304eissn
0959-8138issn
1756-1833journal_volume
323pub_type
杂志文章abstract:OBJECTIVE:To evaluate the associations between personal use of permanent hair dyes and cancer risk and mortality. DESIGN:Prospective cohort study. SETTING AND PARTICIPANTS:117 200 women enrolled in the Nurses' Health Study, an ongoing prospective cohort study of female nurses in the United States. The women were free...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m2942
更新日期:2020-09-02 00:00:00
abstract:OBJECTIVE:To assess the effect on time to diagnosis of recurrence and on quality of life of transferring primary responsibility for follow up of women with breast cancer in remission from hospital to general practice. DESIGN:Randomised controlled trial with 18 month follow up in which women received routine follow up ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.313.7058.665
更新日期:1996-09-14 00:00:00
abstract:OBJECTIVE:To analyse the risk of second primary cancers during long term follow up of patients with Hodgkin's disease. DESIGN:Cohort study. SETTING:The British National Lymphoma Investigation (a collaborative group of over 60 participating centres in Britain treating lymphomas). PATIENTS:2846 patients first treated ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6835.1137
更新日期:1992-05-02 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of a self help approach to smoking cessation in pregnancy. DESIGN:Pragmatic cluster randomised controlled trial with community midwife as the unit of randomisation. SETTING:Three NHS hospital trusts in England. PARTICIPANTS:1527 women who smoked at the start of pregnancy. IN...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.325.7377.1383
更新日期:2002-12-14 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of elective single embryo transfer versus double embryo transfer on the outcomes of live birth, multiple live birth, miscarriage, preterm birth, term singleton birth, and low birth weight after fresh embryo transfer, and on the outcomes of cumulative live birth and multiple live b...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.c6945
更新日期:2010-12-21 00:00:00
abstract:OBJECTIVE:To determine the efficacy of high dose folic acid supplementation for prevention of pre-eclampsia in women with at least one risk factor: pre-existing hypertension, prepregnancy diabetes (type 1 or 2), twin pregnancy, pre-eclampsia in a previous pregnancy, or body mass index ≥35. DESIGN:Randomised, phase III...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.k3478
更新日期:2018-09-12 00:00:00
abstract::Cancer control encompasses the whole spectrum from prevention and early diagnosis to treatment and palliation. The key to the future of cancer control will be to establish multidisciplinary approaches to each type of cancer across this spectrum. For primary prevention this requires some understanding of the causes of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.309.6952.449
更新日期:1994-08-13 00:00:00
abstract:OBJECTIVE:To assess whether occupational exposure among commercial airline cabin attendants are associated with risk of cancer. DESIGN:Record linkage study. SETTING:Finland. SUBJECTS-1577 female and 187 male cabin attendants who had worked for the Finnish airline companies. MAIN OUTCOME MEASURE:Standardised incidenc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7006.649
更新日期:1995-09-09 00:00:00
abstract:OBJECTIVE:To compare the clinical effectiveness of local corticosteroid injection, standard non-steroidal anti-inflammatory drugs, and simple analgesics for the early treatment of lateral epicondylitis in primary care. DESIGN:Multicentre pragmatic randomised controlled trial. SETTING:23 general practices in North Sta...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.319.7215.964
更新日期:1999-10-09 00:00:00
abstract:OBJECTIVE:To examine the association between warfarin treatment and longitudinal outcomes after ischemic stroke in patients with atrial fibrillation in community practice. DESIGN:Observational study. SETTING:Hospitals (n = 1487) participating in the Get With The Guidelines (GWTG)-Stroke program in the United States, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h3786
更新日期:2015-07-31 00:00:00
abstract:OBJECTIVE:Firstly, to assess the completeness of ascertainment in the National Congenital Anomaly System (NCAS), the basis for congenital anomaly surveillance in England and Wales, and its variation by defect, geographical area, and socioeconomic deprivation. Secondly, to assess the impact of the lack of data on pregna...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38300.665301.3A
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVE:To establish the extent of prescribing injectable and oral methadone to opiate addicts and the practice characteristics and dispensing arrangements attached to these prescriptions. DESIGN:National survey of 25% random sample of community (high street) pharmacies through postal questionnaire, with four mailin...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7052.270
更新日期:1996-08-03 00:00:00
abstract:OBJECTIVE:To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. DESIGN:Observational study. SETTING:China's National Maternal Near Miss Surveillance Sy...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.k817
更新日期:2018-03-05 00:00:00
abstract:OBJECTIVE:To identify major concerns of national and local importance in the provision, commissioning, research, and use of generalist end of life care. DESIGN:A national consultation and prioritising exercise using a modified form of the nominal group technique. PARTICIPANTS:Healthcare practitioners, commissioners, ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.a1720
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and costs of a multifaceted flexible educational programme aimed at reducing antibiotic dispensing at the practice level in primary care. DESIGN:Randomised controlled trial with general practices as the unit of randomisation and analysis. Clinicians and researchers were blinded ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.d8173
更新日期:2012-02-02 00:00:00
abstract:OBJECTIVES:To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month. DESIGN:Prospective study of all adults consulting in general practice because of low back pain over 12 months with follow up at 1 week, 3 months, and 12 months after consultation. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7141.1356
更新日期:1998-05-02 00:00:00
abstract:OBJECTIVE:To determine the prevalence of HIV among pregnant women, in particular those whose behaviour or that of their partners put them at "low risk" of infection. DESIGN:Voluntary named or anonymous HIV testing of pregnant women during 21 months (November 1988 to July 1990). SUBJECTS AND SETTING:All women who plan...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6834.1082
更新日期:1992-04-25 00:00:00
abstract:OBJECTIVES:To investigate whether the use of graduated compression stockings (GCS) offers any adjuvant benefit when pharmaco-thromboprophylaxis is used for venous thromboembolism prophylaxis in patients undergoing elective surgery. DESIGN:Open, multicentre, randomised, controlled, non-inferiority trial. SETTING:Seven...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.m1309
更新日期:2020-05-13 00:00:00
abstract::Screening for lung cancer with low dose computed tomography can reduce mortality from the disease by 20% in high risk smokers. This review covers the state of the art knowledge on several aspects of implementing a screening program. The most important are to identify people who are at high enough risk to warrant scree...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.g2253
更新日期:2014-05-27 00:00:00
abstract:OBJECTIVE:To quantify the association between stressful life events and exacerbations of multiple sclerosis. DATA SOURCES:PubMed, PsychInfo, and Psychological Abstracts searched for empirical papers from 1965 to February 2003 with terms "stress", "trauma", and "multiple sclerosis". REVIEW METHODS:Three investigators ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.38041.724421.55
更新日期:2004-03-27 00:00:00
abstract:OBJECTIVE:To assess the risk of bias associated with missing outcome data in systematic reviews. DESIGN:Imputation study. SETTING:Systematic reviews. POPULATION:100 systematic reviews that included a group level meta-analysis with a statistically significant effect on a patient important dichotomous efficacy outcome...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.m2898
更新日期:2020-08-26 00:00:00
abstract:OBJECTIVE:To compare the mortality of patients in a palliative care unit on working days with that on weekends and public holidays. DESIGN:Retrospective database study. SETTING:Palliative care unit in Germany. POPULATION:All admissions to palliative care unit between 1 January 1997 and 31 December 2008. MAIN OUTCOM...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.g7370
更新日期:2014-12-16 00:00:00
abstract:OBJECTIVE:To evaluate the relative efficacy of programmed cell death 1 (PD-1) or programmed cell death ligand 1 (PD-L1) inhibitors versus conventional drugs in patients with cancer that were PD-L1 positive and PD-L1 negative. DESIGN:Meta-analysis of randomised controlled trials. DATA SOURCES:PubMed, Embase, Cochrane ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.k3529
更新日期:2018-09-10 00:00:00
abstract::To study a range of possible risk factors for HIV among injecting drug user patients attending a clinic in London were interviewed from November 1986 to November 1987. Serum samples were tested for viral markers. Of 116 patients, 101 had shared injecting equipment, 75 on the first occasion of injecting and 76 during t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6680.1081
更新日期:1989-04-22 00:00:00
abstract:OBJECTIVE:To independently evaluate the impact of the second phase of the Health Foundation's Safer Patients Initiative (SPI2) on a range of patient safety measures. Design A controlled before and after design. Five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in med...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d199
更新日期:2011-02-03 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of an intervention to enhance self management support for patients with chronic conditions in UK primary care. DESIGN:Pragmatic, two arm, cluster randomised controlled trial. SETTING:General practices, serving a population in northwest England with high levels of deprivation. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.f2882
更新日期:2013-05-13 00:00:00
abstract:OBJECTIVE:To assess whether a late evening meal would improve nitrogen balance in patients with cirrhosis of the liver. DESIGN:Randomised crossover study of meal schedules comparing three meals a day with four or six meals a day, the four and six meal schedules both including a late evening meal (2300). SETTING:Metab...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6709.1202
更新日期:1989-11-11 00:00:00
abstract:OBJECTIVE:To study the processes involved in and impact of mergers between NHS trusts, including the effect on management costs. DESIGN:Cross sectional study involving in depth interviews and documentary analysis; case study to compare savings in management costs between case trusts and control trusts. SETTING:Nine t...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.325.7358.246
更新日期:2002-08-03 00:00:00
abstract:OBJECTIVE:To assess the risk of adverse perinatal events of vaccination of pregnant women with an MF59 adjuvanted vaccine. DESIGN:Cross sectional multicentre study. SETTING:49 public hospitals in major cities in Argentina, from September 2010 to May 2011. PARTICIPANTS:30,448 mothers (7293 vaccinated) and their 30,76...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.f393
更新日期:2013-02-04 00:00:00
abstract:OBJECTIVES:To examine the association of plasma caffeine concentrations during pregnancy with fetal growth and to compare this with relations with reported caffeine intake. DESIGN:Prospective population based study. SETTING:District general hospital, inner London. SUBJECTS:Women booking for delivery between 1982 and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7069.1358
更新日期:1996-11-30 00:00:00