Critical appraisal:Bright T, Watson DI, Tam W, Game PA, Ackroyd R, Devitt PG, et al 2009

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Critical Appraisal

Article being appraised

Bright T, Watson DI, Tam W, Game PA, Ackroyd R, Devitt PG, et al. Prospective randomized trial of argon plasma coagulation ablation versus endoscopic surveillance of Barrett's esophagus in patients treated with antisecretory medication. Dig Dis Sci 2009 Dec;54(12):2606-11 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19101798.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Number of Patients:

57


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
High risk of bias Comments: Well designed study but outcomes were not blinded from the investigators. Drop out rate was 10% but this was distributed evenly between treatment and control arms.

Risk of bias assessment: randomised controlled trial

Was the trial double-blinded?
Outcomes not blinded, substantial side-effects, or not reported.
Was the treatment allocation schedule concealed?
Adequately concealed (e.g. central randomisation, numbered or coded bottles, drugs prepared by pharmacy).
Were all randomised participants included in the analysis?
Exclusions not likely to cause bias (>80% follow-up for all groups, <5% difference in follow-up between groups)
The field below is not considered when calculating the risk of bias rating
How was the allocation schedule generated?
Adequate (e.g. random number table, computer random generator, coin tossing, card shuffling)
Size of effect
1 Reason for decision: The outcome between the treatment and control groups is very significantly different. In essence the mucosa is unchanged in the control group and most ablated (95+%) in the treatment group.
Relevance of evidence
2 Additional comments: The study was conducted in patients with non-dysplastic Barrett's mucosa
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Mark Schoeman MBBS, PhD, FRACP, AGAF


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


Article
Bright T, Watson DI, Tam W, Game PA, Ackroyd R, Devitt PG, et al. Prospective randomized trial of argon plasma coagulation ablation versus endoscopic surveillance of Barrett's esophagus in patients treated with antisecretory medication. Dig Dis Sci 2009 Dec;54(12):2606-11 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19101798.
Assigned to
User:Mark.schoeman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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