Critical appraisal:Edelstein ZR, Bronner MP, Rosen SN, Vaughan TL 2009

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Critical Appraisal

Article being appraised

Edelstein ZR, Bronner MP, Rosen SN, Vaughan TL. Risk factors for Barrett's esophagus among patients with gastroesophageal reflux disease: a community clinic-based case-control study. Am J Gastroenterol 2009 Apr;104(4):834-42 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19319131.


Applicable clinical question

Key Facts

Study Design

case-control study

Number of Patients:

612


Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
High risk of bias Comments: Although the summary evidence rating is low, this is a high-quality observational epidemiological study. The low score reflects lack of information about blinding.

Risk of bias assessment: case-control study

Subject selection
Cases
Selected group (e.g. multi-institution study)
Adequacy of case definition
Independent validation of outcome (blind to exposure status)
Controls
From same population as cases and same exclusion criteria used
Comparability of groups on demographic characteristics and important potential confounders
Comparable (or matched)
Ascertainment of exposure/treatment
No or not described
Follow-up complete and all patients included in the analysis?
Non-response unlikely to introduce bias (>80% in both cases and controls)
Size of effect
1 Reason for decision: BMI
  <25      1.0 ref
25-29.9 0.9 (0.5-1.6)
30+ 1.1 (0.6-2.1)


WAIST CIRCUMFERENCE

  Low      1.0 ref
Med 1.6 (0.8-3.1)
High 1.7 (0.9-3.5)

WAIST HIP RATIO

  Low      1.0 ref
High 1.9 (1.0-3.5)

WAIST THIGH RATIO

  Low      1.0 ref
Med 2.2 (1.1-4.1)
High 2.2 (1.1-4.3)

SMOKING

  Never    1.0 ref
Former 1.8 (1.2-2.6)
Current 1.8 (1.0-3.0)

PACK YEARS

  Never    1.0 ref
<13.5 1.7 (1.1-2.6)
13.5+ 1.9 (1.2-2.9)
Relevance of evidence
1 Additional comments: The exposure measures are valid and the outcomes are relevant to patients
Result of appraisal

Jutta's tick icon.png Included




Completed by

David Whiteman


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Article
Edelstein ZR, Bronner MP, Rosen SN, Vaughan TL. Risk factors for Barrett's esophagus among patients with gastroesophageal reflux disease: a community clinic-based case-control study. Am J Gastroenterol 2009 Apr;104(4):834-42 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19319131.
Assigned to
User:David.whiteman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

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