Critical appraisal:Dulai GS, Jensen DM, Cortina G, Fontana L, Ippoliti A 2005

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Critical Appraisal

Article being appraised

Dulai GS, Jensen DM, Cortina G, Fontana L, Ippoliti A. Randomized trial of argon plasma coagulation vs. multipolar electrocoagulation for ablation of Barrett's esophagus. Gastrointest Endosc 2005 Feb;61(2):232-40 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15729231.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Number of Patients:

52


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
High risk of bias Comments: Well designed study with patients properly randomised to one of two treatment groups. Outcome assessments were made blind to the treatment protocol. The treatment groups however were not the same as the APC group had statistically longer segment of Barrett's mucosa than the MPEC treated group. This ultimately influenced the number of treatment sessions required in the APC group.

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?
Inadequately concealed (e.g. numbered/sealed envelopes, alternation, medical record number, date of birth).
Were all randomised participants included in the analysis?
No exclusions or survival analysis used with all subjects included (>95% follow-up for all groups).
The field below is not considered when calculating the risk of bias rating
How was the allocation schedule generated?
Inadequate or not reported
Size of effect
2 Reason for decision: Ablation was performed in non-dysplastic mucosa and was effective. It does not contribute to the question of ablation in patients with dysplastic mucosa
Relevance of evidence
2 Additional comments: The treatments are both able to induce regression of Barrett's mucosa
Result of appraisal

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Completed by

Dr Mark Schoeman MBBS, PhD, FRACP, AGAF


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Article
Dulai GS, Jensen DM, Cortina G, Fontana L, Ippoliti A. Randomized trial of argon plasma coagulation vs. multipolar electrocoagulation for ablation of Barrett's esophagus. Gastrointest Endosc 2005 Feb;61(2):232-40 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15729231.
Assigned to
User:Mark.schoeman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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