Critical appraisal:Ayers K, Shi C, Washington K, Yachimski P 2013

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Critical Appraisal

Article being appraised

Ayers K, Shi C, Washington K, Yachimski P. Expert pathology review and endoscopic mucosal resection alters the diagnosis of patients referred to undergo therapy for Barrett's esophagus. Surg Endosc 2013 Aug;27(8):2836-40 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23389078.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

29


Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
No, but objective measures used
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
5 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
3 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

Jutta's tick icon.png Included


Reason for decision

This study does not address the clinical question.

Comments

This study is a single-centre, case-series of 29 patients undergoing EMR for Barrett's staging comparing referral histological diagnosis from biopsy samples to diagnosis following expert histological review of referral biopsy samples and EMR. The combination of expert histopathologic review and EMR altered the initial diagnosis for 55 % (16/29) of the subjects, with 56 % (9/16) upstaged to more advanced disease and 44 % (7/16) downstaged to less advanced disease.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


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


Article
Ayers K, Shi C, Washington K, Yachimski P. Expert pathology review and endoscopic mucosal resection alters the diagnosis of patients referred to undergo therapy for Barrett's esophagus. Surg Endosc 2013 Aug;27(8):2836-40 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/23389078.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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