Table 1 Case histories and questions presented to the informants.

Patient 1. A 30-year-old man with symptoms from the upper part of the abdomen. The patient has had intermittent pain, made worse by stress, for a few years. One year ago an ultrasound examination and an oesophagogastroduodenoscopy were performed. No abnormal findings were registered. H. pylori serology was negative.

Patient 2. A 30-year-old man with symptoms from the upper part of the abdomen. The patient has had intermittent pain, made worse by stress, for a few years. One year ago an ultrasound examination and an oesophagogastroduodenoscopy were performed. No abnormal findings were registered. H. pylori serology was positive.

Patient 3. A 30-year-old overweight man with symptoms from the upper part of the abdomen and retrosternally. The pain worsens when he leans forward and when he rests in a prone position. He sometimes experiences a sour or bitter taste in his mouth. H. pylori serology was positive.

Patient 4. A 30-year-old man with symptoms from the upper part of the abdomen. The ultrasound examination revealed nothing abnormal, but the oesophagogastroduodenoscopy indicated a duodenal ulcer.

After each case the following questions were asked:

A. Do you think that it is a problem to decide whether there is a need for treatment in a case like this? If yes: What problems?

B. How would you manage a case like this?

C. Which factors do you think are most important to consider in your decision?

D. What do you believe your colleagues would decide in a case like this?