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Our aim was to determine the most important treatment strategies used in Europe, to evaluate first-line treatment effectiveness according to year and country. Data collection: All first-line empirical treatments registered at AEGREDCap in the European Registry on Helicobacter pylori management (Hp-EuReg) from June 2013 to November 2022. A Boruta method determined the \u201cmost important\u201d variables related to treatment effectiveness. Data clustering was performed through multi-correspondence analysis of the resulting six most important variables for every year in the 2013\u20132022 period. Based on 35,852 patients, the average overall treatment effectiveness increased from 87% in 2013 to 93% in 2022. The lowest effectiveness (80%) was obtained in 2016 in cluster #3 encompassing Slovenia, Lithuania, Latvia, and Russia, treated with 7-day triple therapy with amoxicillin\u2013clarithromycin (92% of cases). The highest effectiveness (95%) was achieved in 2022, mostly in Spain (81%), with the bismuth\u2013quadruple therapy, including the single-capsule (64%) and the concomitant treatment with clarithromycin\u2013amoxicillin\u2013metronidazole\/tinidazole (34%) with 10 (69%) and 14 (32%) days. Cluster analysis allowed for the identification of patients in homogeneous treatment groups assessing the effectiveness of different first-line treatments depending on therapy scheme, adherence, country, and prescription year.<\/jats:p>","DOI":"10.3390\/antibiotics12091427","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T09:00:52Z","timestamp":1694422852000},"page":"1427","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Analysis of Clinical Phenotypes through Machine Learning of First-Line H. pylori Treatment in Europe during the Period 2013\u20132022: Data from the European Registry on H. pylori Management (Hp-EuReg)"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-9310","authenticated-orcid":false,"given":"Olga P.","family":"Nyssen","sequence":"first","affiliation":[{"name":"Digestive System Service of the Hospital Universitario de La Princesa, 28006 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), 28006 Madrid, Spain"},{"name":"Departamento de Medicina, Universidad Aut\u00f3noma de Madrid (UAM), 28049 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Pratesi","sequence":"additional","affiliation":[{"name":"Dipartimento di Statistica e Metodi Quantitativi (DISMEQ), Universit\u00e1 degli studi di Milano\u2013Bicocca, 20126 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel A.","family":"Sp\u00ednola","sequence":"additional","affiliation":[{"name":"Unidad de An\u00e1lisis de Datos del Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS-Princesa), 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9086-3675","authenticated-orcid":false,"given":"Laimas","family":"Jonaitis","sequence":"additional","affiliation":[{"name":"Institute for Digestive Research, Department of Gastroenterology, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2974-1382","authenticated-orcid":false,"given":"\u00c1ngeles","family":"P\u00e9rez-A\u00edsa","sequence":"additional","affiliation":[{"name":"Hospital Universitario Costa del Sol, 29603 Marbella, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dino","family":"Vaira","sequence":"additional","affiliation":[{"name":"Department of Surgical and Medical Sciences, Sant\u2019Orsola-Malpighi University Hospital, 40138 Bologna, Italy"},{"name":"Cardiovascular Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4388-7089","authenticated-orcid":false,"given":"Ilaria Maria","family":"Saracino","sequence":"additional","affiliation":[{"name":"Department of Surgical and Medical Sciences, Sant\u2019Orsola-Malpighi University Hospital, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pavoni","sequence":"additional","affiliation":[{"name":"Department of Surgical and Medical Sciences, Sant\u2019Orsola-Malpighi University Hospital, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Fiorini","sequence":"additional","affiliation":[{"name":"Department of Surgical and Medical Sciences, Sant\u2019Orsola-Malpighi University Hospital, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bojan","family":"Tepes","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, DC Rogaska, 3250 Rogaska Slatina, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2815-3992","authenticated-orcid":false,"given":"Dmitry S.","family":"Bordin","sequence":"additional","affiliation":[{"name":"Department of Pancreatic, Biliary and Upper Digestive Tract Disorders, A. 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