Critical appraisal:Chennat J, Konda VJ, Ross AS, de Tejada AH, Noffsinger A, Hart J, et al 2009 2

From Cancer Guidelines Wiki

Critical Appraisal

Article being appraised

Chennat J, Konda VJ, Ross AS, de Tejada AH, Noffsinger A, Hart J, et al. Complete Barrett's eradication endoscopic mucosal resection: an effective treatment modality for high-grade dysplasia and intramucosal carcinoma--an American single-center experience. Am J Gastroenterol 2009 Nov;104(11):2684-92 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19690526.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

49


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: Outcome data re efficacy and safety, no comparison group
Relevance of evidence
1 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 cohort study examining the efficacy and safety of endoscopic mucosal resection for treatment of HGD/IMC in Barrett's, with moderate long-term outcome data (mean 22 months). This does not answer the question of how frequently one should perform surveillance in HGD but does inform the debate by demonstrating the efficay and safety of endoscopic therapy in HGD, in selected patients and in expert hands. This adds weight to the notion that therapy rather than surveillance should be preferred in HGD.

Completed by

Dr Mark Appleyard MD FRACP MRCP MBBS BSc


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


Article
Chennat J, Konda VJ, Ross AS, de Tejada AH, Noffsinger A, Hart J, et al. Complete Barrett's eradication endoscopic mucosal resection: an effective treatment modality for high-grade dysplasia and intramucosal carcinoma--an American single-center experience. Am J Gastroenterol 2009 Nov;104(11):2684-92 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19690526.
Assigned to
User:Mark.appleyard
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

Edit appraisal assignment