Loren Laine, MD; M. Brian Fennerty, MD; Philip Schoenfeld, MD, MSEd
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Laine L, Fennerty MB, Schoenfeld P. Helicobacter pylori Eradication Therapy for Nonulcer Dyspepsia. Ann Intern Med. 2002;136:556. doi: 10.7326/0003-4819-136-7-200204020-00019
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Published: Ann Intern Med. 2002;136(7):556.
Meta-analysis involves more than calculating a summary estimate from an amalgamation of studies. The letter and meta-analysis of Drs. Moayyedi, Deeks, and Forman illustrate the need to assess other factors before drawing conclusions. The widely accepted definition of dyspepsia is upper abdominal pain or discomfort, excluding predominant reflux symptoms. Although Moayyedi and colleagues state that they excluded trials including participants with only reflux symptoms, the two positive trials in their meta-analysis included patients with reflux (1, 2). They report that a third trial was positive, but treatment success, the primary end point, did not improve with therapy (3). Analysis of studies in their review using the appropriate definition of dyspepsia shows no benefit (P = 0.5), just as in our meta-analysis.
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