Critical appraisal:Abrams JA, Kapel RC, Lindberg GM, Saboorian MH, Genta RM, Neugut AI, et al 2009

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Critical Appraisal

Article being appraised

Abrams JA, Kapel RC, Lindberg GM, Saboorian MH, Genta RM, Neugut AI, et al. Adherence to biopsy guidelines for Barrett's esophagus surveillance in the community setting in the United States. Clin Gastroenterol Hepatol 2009 Jul;7(7):736-42; quiz 710 Available from: http://www.ncbi.nlm.nih.gov/pubmed/19268726.


Applicable clinical question

Key Facts

Study Design

cohort study

Number of Patients:

2245


Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
High risk of bias Comments: Community cohort study using large pathology and endoscopy databas. Comparison of outcome of dysplasia detection in those patients who did and didn't have biopsies according to guidelines.

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Highly selected or not described
Comparison group
Highly selected or not described
Comparability of groups on demographic characteristics and clinical features
Not comparable and not adjusted for differences
Measurement of outcomes
Outcome measures blind to technology used
Yes
Same method of measurement used across comparison groups
No or not described
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Yes (follow-up >95%) or survival analysis using all patients
Size of effect
1 Reason for decision: Non adherence was associated with a significantly decreased dysplasia detection rate (Summary OR 0.53, 95%CI 0.35-0.82)
Relevance of evidence
1 Additional comments: Effect on patient relevant outcome (detection of dysplasia).
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Bradley Kendall MBBS, FRACP


Jutta's tick icon.png This appraisal has been completed.


Article
Abrams JA, Kapel RC, Lindberg GM, Saboorian MH, Genta RM, Neugut AI, et al. Adherence to biopsy guidelines for Barrett's esophagus surveillance in the community setting in the United States. Clin Gastroenterol Hepatol 2009 Jul;7(7):736-42; quiz 710 Available from: http://www.ncbi.nlm.nih.gov/pubmed/19268726.
Assigned to
User:Brad.kendall
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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