Critical appraisal:Andrici J, Tio M, Cox MR, Eslick GD 2012

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Critical Appraisal

Article being appraised

Andrici J, Tio M, Cox MR, Eslick GD. Hiatal Hernia and the Risk of Barrett's Esophagus: A Meta-Analysis. J Gastroenterol Hepatol 2012 Jun 13 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22694245.


Applicable clinical question

Key Facts

Study Design

systematic review — the review included all observational studies addressing the topic, including case-control and cohort studies which included an internal control group and which had a total sample size > 50 patients

Number of Patients:

47461


Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
Moderate risk of bias Comments:

Risk of bias assessment: systematic review

Studies included in the review
Was an adequate search strategy used?
Adequate – search terms and/or choice of databases could have been improved upon
Were the inclusion criteria appropriate and applied in an unbiased way?
Yes – pre-specified inclusion criteria applied independently by two people
Were the studies assessed for quality (relating to the minimisation of biases)?
No – quality assessment either not undertaken, inappropriate or not described
Were the characteristics and results of individual studies appropriately summarised?
Yes – summary descriptive tables of subjects, interventions, outcomes etc are provided and estimates of treatment effect displayed
The following questions are only relevant for systematic reviews that pooled data
Were the methods used for pooling the data appropriate?
Yes
If there was heterogeneity, were sources of heterogeneity explored?
Yes
Size of effect
1 Reason for decision: Hiatus hernia - any BE OR 3.94 95%CI 3.02-5.13

Hiatus hernia - Short segment BE OR 2.87 95%CI 1.75-4.70
Hiatus hernia - Long segment BE OR 12.67 95%CI 8.33-19.25

Relevance of evidence
1 Additional comments: This was a systematic review of case-control studies and cross-sectional studies. The NHMRC hierarchy is not clear about the level of evidence for such studies. The exposure measures are valid and the outcomes are relevant to patients
Result of appraisal

Jutta's tick icon.png Included




Completed by

Professor David Whiteman B Med Sci, MBBS (Hons) PhD FAFPHM


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


Article
Andrici J, Tio M, Cox MR, Eslick GD. Hiatal Hernia and the Risk of Barrett's Esophagus: A Meta-Analysis. J Gastroenterol Hepatol 2012 Jun 13 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22694245.
Assigned to
User:David.whiteman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

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