Helicobacter pylori eradication in long‐term proton pump inhibitor users in primary care: a randomized‐controlled trial
Bibliographic record
Abstract
BACKGROUND: Two-thirds of proton pump inhibitor prescribing in the UK is for long-term therapy. AIM: To determine the impact of eradication in long-term proton pump inhibitor users infected with Helicobacter pylori. METHODS: A total of 184 H. pylori-positive patients were randomly assigned to true or placebo eradication therapy. The primary outcome was the change in proton pump inhibitor usage measured by prescriptions; secondary outcomes were changes of proton pump inhibitor doses, dyspepsia symptoms, general practitioner consultations and quality of life measures. RESULTS: In the year following H. pylori eradication proton pump inhibitor prescriptions fell compared with placebo (-1.7, 95% CI: -2.3 to -1.1, P < 0.001); when adjusted to full-dose equivalent prescriptions the reduction was more marked (-2.2, 95% CI: -3.0 to -1.4, P < 0.001). Both general practitioner consultations (-1.0, 95% CI: -1.8 to -0.1, P = 0.026) and symptoms measured on the Leeds Dyspepsia Questionnaire (-3.1, 95% CI: -5.3 to -0.9, P = 0.005) were reduced. Quality of life and self-rating measures also favoured eradication (EQ-5D: 0.09, P = 0.08 and VAS: 5.6, P = 0.002). The Carlsson and Dent Reflux Questionnaire found no difference between groups (-0.3, P = 0.65), possibly balancing decreased overall symptoms with increased prominence of heartburn in the eradication group. CONCLUSIONS: Helicobacter pylori eradication in infected, long-term proton pump inhibitor users in primary care reduced both the overall severity of symptoms and use of health care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".