OUTCOMES RESEARCH IN HELICOBACTER-PYLORI INFECTION

While the medical community has accepted the role of H. pylori in the pathogenesis of peptic ulcer disease, confusion persists among clinici ans regarding when and on which patients to attempt H. pylori eradicat ion, Thus, the objective for outcomes research in H. pylori is to help clinicians identify which patients benefit from H. pylori eradication and to determine the cost-effective strategies for their diagnosis, t reatment and follow-up care, Economic evaluation of the impact of H. p ylori infection has focused primarily on assessment of patient with do cumented peptic ulcer disease, with particular attention to costs of p harmaceuticals. However, drug costs are only one portion of the total costs of management for patients with acid-related disorders and there fore must be put in the appropriate context, Additional aspects of pat ient benefit (e.g. patient satisfaction) and health-care expenditures (e.g. over-the-counter medications, specialist visits, hospitalization s) must be included in an evaluation of the value of a particular diag nostic test, treatment, clinical guideline or disease management strat egy, As a result of the high quality and quantity of data emerging, it can be safely said that H. pylori eradication is cost-effective in se lected patient populations: newly documented peptic ulcer disease; his tory of peptic ulcer disease and taking maintenance therapy; and suspe cted peptic ulcer disease using a serological test to guide initial tr eatment. The role of eradication in other areas, for example, patients with non-ulcer dyspepsia and screening to prevent gastric cancer, rem ains to be seen. In addition to the performance of rigorous studies, r esearchers must respond to the 'information overload' on busy clinicia ns, by effectively disseminating their findings, If data generated fro m outcomes research are not integrated into everyday clinical practice , the enormous benefits associated with H. pylori eradication will not be achieved.