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We examined these issues in a large managed care system in the <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>outhwestern <jats:styled-content style=\"fixed-case\">U<\/jats:styled-content>nited <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective case\u2013control analysis of adults with incident dyspepsia or a <jats:italic><jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>elicobacter pylori<\/jats:italic>\u2010related condition in years 2006 through 2010 using utilization data. Medical record abstraction of 400 cases was conducted to obtain additional clinical information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6989 cases met all inclusion and exclusion criteria. Women had a substantially higher risk of dyspepsia than men (14 per 1000 per year vs 10 per 1000; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001), and the incidence of dyspepsia increased with age such that persons in their seventh decade had almost twice the risk of those aged 18\u201329. Hispanic persons had a significantly higher risk of dyspepsia and positive <jats:italic>H.\u00a0pylori<\/jats:italic> testing. Dyspepsia cases had a higher prevalence of other chronic comorbidities than their matched controls. Dyspepsia patients had healthcare costs 54% higher than controls even before the diagnosis was made, and costs in the initial diagnostic period were $483 greater per person, but subsequent costs were not greatly affected. Among those aged 55 and younger, the \u201ctest and treat\u201d approach was used in 53% and another 18% had an initial esophagogastroduodenoscopy, as compared to 47 and 27%, respectively, among those over the age of 55.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women and older adults have a higher incidence of dyspepsia than previously appreciated, and <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ispanics in this region also have a higher risk. Current guidelines for dyspepsia evaluation are only loosely followed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1523-5378.2012.00988.x","type":"journal-article","created":{"date-parts":[[2012,9,4]],"date-time":"2012-09-04T04:15:56Z","timestamp":1346732156000},"page":"54-65","source":"Crossref","is-referenced-by-count":23,"title":["The Epidemiology, Diagnosis, and Cost of Dyspepsia and <i><scp>H<\/scp>elicobater pylori<\/i> Gastritis: A Case\u2013Control Analysis in the <scp>S<\/scp>outhwestern <scp>U<\/scp>nited <scp>S<\/scp>tates"],"prefix":"10.1111","volume":"18","author":[{"given":"Douglas","family":"Mapel","sequence":"first","affiliation":[{"name":"Lovelace Clinic Foundation Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Roberts","sequence":"additional","affiliation":[{"name":"Lovelace Clinic Foundation Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Overhiser","sequence":"additional","affiliation":[{"name":"Northern Arizona Gastroenterology Flagstaff AZ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Mason","sequence":"additional","affiliation":[{"name":"Southwest Gastroenterology Associates Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,9,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.1996.tb00177.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2000.00728.x"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.77.910.514"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200209000-00009"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmm050"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000211715"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01080.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.31.8.940"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v12.i3.354"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.09.019"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.09.020"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.08724.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.533"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra020542"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01819.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa001999"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01381.x"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2007.07.007"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(00)00256-0"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199801000-00004"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2006.04.029"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.01897.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.05.015"},{"key":"e_1_2_7_25_1","first-page":"37","article-title":"Practice patterns for managing Helicobacter pylori infection and upper gastrointestinal symptoms","volume":"13","author":"Howden CW","year":"2007","journal-title":"Am J Manag Care"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b975b8"},{"key":"e_1_2_7_27_1","first-page":"1","article-title":"Seroprevalence of six infectious diseases among adults in the United States by race\/ethnicity: data from the third national health and nutrition examination survey, 1988\u201394","volume":"352","author":"Kruszon\u2010Moran D","year":"2005","journal-title":"Adv Data"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01393.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.72.Suppl_2.S1"},{"key":"e_1_2_7_30_1","unstructured":"Unit NGDaR.Management of dyspepsia in adults in primary care. 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