Critical appraisal:Buskens CJ, Westerterp M, Lagarde SM, Bergman JJ, ten Kate FJ, van Lanschot JJ 2004

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Critical Appraisal

Article being appraised

Buskens CJ, Westerterp M, Lagarde SM, Bergman JJ, ten Kate FJ, van Lanschot JJ. Prediction of appropriateness of local endoscopic treatment for high-grade dysplasia and early adenocarcinoma by EUS and histopathologic features. Gastrointest Endosc 2004 Nov;60(5):703-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15557945.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

77


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



Comments

This is a retrospective single-institution case series of 77 patients with HGD or T1 adenocarcinoma who underwent esophagectomy. EUS correctly predicted the absence of positive LNs in 57 of 61 patients (93%). In 4 patients the presence of a positive LN was missed but SM invasion was correctly predicted. No patient with a superficial lesion (HGD, T1im, T1mm) had positive LNs as was predicted by EUS.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


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


Article
Buskens CJ, Westerterp M, Lagarde SM, Bergman JJ, ten Kate FJ, van Lanschot JJ. Prediction of appropriateness of local endoscopic treatment for high-grade dysplasia and early adenocarcinoma by EUS and histopathologic features. Gastrointest Endosc 2004 Nov;60(5):703-10 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15557945.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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