{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T23:25:46Z","timestamp":1767828346475,"version":"3.49.0"},"reference-count":34,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T00:00:00Z","timestamp":1581379200000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,1,6]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To formulate a decision analysis model based on recently published data that addresses the dilemma, whether improvement in quality of life rationalises continued proton pump inhibitors (PPI) use despite the risk of gastric cancer (GC) in patients with functional dyspepsia (FD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A Markov model consisting of an initial decision regarding treatment with PPI (denoting it by PPI strategy) or any other treatment without PPI (denoting it by placebo strategy) was designed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>Data from prospective cross-sectional studies indicating risk stratification for GC after the use of PPI, combined with a Markov model that comprised the following states: Live, GC stages 1\u20134, Death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The primary outputs included quality-adjusted life years (QALYs) and life expectancy (LE). The improvement in utility in FD without PPI as compared with PPI use was tested (PPI vs placebo strategies). Sensitivity analyses were performed to evaluate the robustness of the model and address uncertainty in the estimation of model parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We considered only patients whose symptoms were relieved with PPIs and thus, had a better quality of life compared with patients who did not receive PPIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The base case model showed that PPIs compared with placebo decreased LE by 58.4 days with a gain of 2.1 QALY. If utility (quality of life of patients with FD using PPI compared with patients with FD without PPI) improved by more than 0.8%, PPI use is considered better than placebo. Older patients benefited less from PPI treatment than did younger patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To bridge the gap between evidence and decision making, we found that even a small improvement in the QALY justified continuing PPI treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-031091","type":"journal-article","created":{"date-parts":[[2020,2,12]],"date-time":"2020-02-12T09:16:00Z","timestamp":1581498960000},"page":"e031091","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Is administration of proton pump inhibitors in functional dyspepsia worth the risk of developing gastric cancer: a Markov model to bridge the gap between scientific evidence and clinical practice"],"prefix":"10.1136","volume":"10","author":[{"given":"Efrat","family":"Broide","sequence":"first","affiliation":[{"name":"The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir Medical Center (Assaf Harofeh Medical), Zerifin, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9677-0453","authenticated-orcid":false,"given":"Adi","family":"Eindor-Abarbanel","sequence":"additional","affiliation":[{"name":"The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir Medical Center (Assaf Harofeh Medical), Zerifin, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haim","family":"Shirin","sequence":"additional","affiliation":[{"name":"The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir Medical Center (Assaf Harofeh Medical), Zerifin, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vered","family":"Richter","sequence":"additional","affiliation":[{"name":"The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir Medical Center (Assaf Harofeh Medical), Zerifin, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shay","family":"Matalon","sequence":"additional","affiliation":[{"name":"The Kamila Gonczarowski Institute of Gastroenterology and Liver Diseases, Shamir Medical Center (Assaf Harofeh Medical), Zerifin, Israel"},{"name":"Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moshe","family":"Leshno","sequence":"additional","affiliation":[{"name":"Coller School of Management, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,12]]},"reference":[{"key":"2025121513590799000_10.2.e031091.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-008-0538-y"},{"key":"2025121513590799000_10.2.e031091.2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599816648298"},{"key":"2025121513590799000_10.2.e031091.3","doi-asserted-by":"crossref","unstructured":"Ali T , Roberts DN , Tierney WM . Long-Term safety concerns with proton pump inhibitors. Am J Med 2009.","DOI":"10.1016\/j.amjmed.2009.04.014"},{"key":"2025121513590799000_10.2.e031091.4","doi-asserted-by":"crossref","unstructured":"Scheiman JM . The use of proton pump inhibitors in treating and preventing NSAID-induced mucosal damage. Arthritis Res Ther 2013.","DOI":"10.1186\/ar4177"},{"key":"2025121513590799000_10.2.e031091.5","doi-asserted-by":"crossref","unstructured":"Lazarus B , Chen Y , Wilson FP , et al . Proton pump inhibitor use and the risk of chronic kidney disease. JAMA Intern Med 2016.","DOI":"10.1001\/jamainternmed.2015.7193"},{"key":"2025121513590799000_10.2.e031091.6","doi-asserted-by":"crossref","unstructured":"Nochaiwong S , Ruengorn C , Awiphan R , et al . The association between proton pump inhibitor use and the risk of adverse kidney outcomes: a systematic review and meta-analysis. Nephrol Dial Transplant 2018.","DOI":"10.1093\/ndt\/gfw470"},{"key":"2025121513590799000_10.2.e031091.7","doi-asserted-by":"crossref","unstructured":"Grant CH , Gillis KA , Lees JS , et al . Proton pump inhibitor use and progression to major adverse renal events: a competing risk analysis. QJM An Int J Med 2019.","DOI":"10.1093\/qjmed\/hcz166"},{"key":"2025121513590799000_10.2.e031091.8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6605024"},{"key":"2025121513590799000_10.2.e031091.9","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1016\/j.cgh.2016.05.018","article-title":"Use of proton pump inhibitors and risks of fundic gland polyps and gastric cancer: systematic review and meta-analysis","volume":"14","author":"Tran-Duy","year":"2016","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2025121513590799000_10.2.e031091.10","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12693"},{"key":"2025121513590799000_10.2.e031091.11","doi-asserted-by":"publisher","DOI":"10.1136\/gut.52.7.942"},{"key":"2025121513590799000_10.2.e031091.12","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.086579"},{"key":"2025121513590799000_10.2.e031091.13","doi-asserted-by":"crossref","unstructured":"Cheung KS , Chan EW , Wong ICK , et al . Long-Term proton pump inhibitors and risk of gastric cancer development after treatment for Helicobacter pylori: a population-based study. Gut 2017:gutjnl-2017-314605.","DOI":"10.1016\/S0016-5085(17)32875-5"},{"key":"2025121513590799000_10.2.e031091.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2017-017739","article-title":"Maintenance therapy with proton pump inhibitors and risk of gastric cancer: a nationwide population-based cohort study in Sweden","volume":"7","author":"Brusselaers","year":"2017","journal-title":"BMJ Open"},{"key":"2025121513590799000_10.2.e031091.15","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1159\/000358111","article-title":"Therapeutic options for functional dyspepsia","volume":"32","author":"Vanheel","year":"2014","journal-title":"Dig Dis"},{"key":"2025121513590799000_10.2.e031091.16","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/2040622317725479","article-title":"Management of functional dyspepsia: state of the art and emerging therapies","volume":"9","author":"Yamawaki","year":"2018","journal-title":"Ther Adv Chronic Dis"},{"key":"2025121513590799000_10.2.e031091.17","doi-asserted-by":"crossref","unstructured":"Pinto-Sanchez MI , Yuan Y , Bercik P , et al . Proton pump inhibitors for functional dyspepsia. Cochrane Database Syst Rev 2017;2017.","DOI":"10.1002\/14651858.CD011194.pub2"},{"key":"2025121513590799000_10.2.e031091.18","doi-asserted-by":"publisher","DOI":"10.7326\/M14-0845"},{"key":"2025121513590799000_10.2.e031091.19","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.bpg.2017.09.002","article-title":"Alcohol, smoking and risk of oesophago-gastric cancer","volume":"31","author":"Dong","year":"2017","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"2025121513590799000_10.2.e031091.20","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.2016.1118050"},{"key":"2025121513590799000_10.2.e031091.21","first-page":"292","article-title":"The prognosis role of AJCC\/UICC 8th edition staging system in gastric cancer, a retrospective analysis","volume":"10","author":"Liu","year":"2018","journal-title":"Am J Transl Res"},{"key":"2025121513590799000_10.2.e031091.22","doi-asserted-by":"crossref","unstructured":"Habbema JDF , Wilt TJ , Etzioni R , et al . Models in the development of clinical practice guidelines. Ann Intern Med 2014.","DOI":"10.7326\/M14-0845"},{"key":"2025121513590799000_10.2.e031091.23","doi-asserted-by":"crossref","unstructured":"Sonnenberg FA , Beck JR . Markov models in medical decision making: a practical guide. Med Decis Mak 1993.","DOI":"10.1177\/0272989X9301300409"},{"key":"2025121513590799000_10.2.e031091.24","doi-asserted-by":"crossref","unstructured":"Heading RC , M\u00f6nnikes H , Tholen A , et al . Prediction of response to PPi therapy and factors influencing treatment outcome in patients with GORD: a prospective pragmatic trial using pantoprazole. BMC Gastroenterol 2011;11.doi:10.1186\/1471-230X-11-52","DOI":"10.1186\/1471-230X-11-52"},{"key":"2025121513590799000_10.2.e031091.25","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.4.502"},{"key":"2025121513590799000_10.2.e031091.26","doi-asserted-by":"crossref","unstructured":"Scarpignato C , Gatta L , Zullo A , et al . Effective and safe proton pump inhibitor therapy in acid-related diseases \u2013 a position paper addressing benefits and potential harms of acid suppression. BMC Med 2016;14.doi:10.1186\/s12916-016-0718-z","DOI":"10.1186\/s12916-016-0718-z"},{"key":"2025121513590799000_10.2.e031091.27","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2017.154"},{"key":"2025121513590799000_10.2.e031091.28","doi-asserted-by":"crossref","unstructured":"Boghossian TA , Rashid FJ , Thompson W , et al . Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev 2017;16.doi:10.1002\/14651858.CD011969.pub2","DOI":"10.1002\/14651858.CD011969.pub2"},{"key":"2025121513590799000_10.2.e031091.29","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1016\/0016-5085(94)90532-0","article-title":"A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. restore investigator group","volume":"107","author":"Smith","year":"1994","journal-title":"Gastroenterology"},{"key":"2025121513590799000_10.2.e031091.30","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199510263331703"},{"key":"2025121513590799000_10.2.e031091.31","doi-asserted-by":"crossref","DOI":"10.1186\/1471-230X-13-145","article-title":"Possible etiology of improvements in both quality of life and overlapping gastroesophageal reflux disease by proton pump inhibitor treatment in a prospective randomized controlled trial","volume":"13","author":"M\u00f6nnikes","year":"2013","journal-title":"BMC Gastroenterol"},{"key":"2025121513590799000_10.2.e031091.32","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/S0140-6736(08)61497-X","article-title":"Proton-Pump inhibitors in peptic ulcer disease","volume":"372","author":"Chan","year":"2008","journal-title":"Lancet"},{"key":"2025121513590799000_10.2.e031091.33","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300551"},{"key":"2025121513590799000_10.2.e031091.34","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr135"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-031091","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:59:15Z","timestamp":1765835955000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-031091"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,2,12]]},"published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1136\/bmjopen-2019-031091"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-031091","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2]]}}}