Critical appraisal:Chang KJ, Soetikno RM, Bastas D, Tu C, Nguyen PT 2003

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Critical Appraisal

Article being appraised

Chang KJ, Soetikno RM, Bastas D, Tu C, Nguyen PT. Impact of endoscopic ultrasound combined with fine-needle aspiration biopsy in the management of esophageal cancer. Endoscopy 2003 Nov 1;35(11):962-6 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/14606021.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

60


Includes an economic evaluation

yes

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?
No or not described
Size of effect
5 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
2 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 prospective, single-centre case series of 60 consecutive patients found accuracy rates of pre-operative EUS combined with FNA for tumor and lymph-node staging of 83% and 89%, respectively. Twenty-five patients (42 %) had EUS stage I and II and were candidates for curative surgery. Patients' medical decisions in favor of surgical or medical therapy correlated strongly with the results of their EUS staging ( P = 0.005), but not with age, sex, or referring physicians (surgeons vs. nonsurgeons). EUS-guided therapy potentially decreased the cost of care by $ 740 424 ($ 12 340/patient) by reducing the number of thoracotomies.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


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


Article
Chang KJ, Soetikno RM, Bastas D, Tu C, Nguyen PT. Impact of endoscopic ultrasound combined with fine-needle aspiration biopsy in the management of esophageal cancer. Endoscopy 2003 Nov 1;35(11):962-6 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/14606021.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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