Critical appraisal:Li YM, Li L, Yu CH, Liu YS, Xu CF 2008 4

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Critical Appraisal

Article being appraised

Li YM, Li L, Yu CH, Liu YS, Xu CF. A systematic review and meta-analysis of the treatment for Barrett's esophagus. Dig Dis Sci 2008 Nov;53(11):2837-46 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18427992.


Applicable clinical question

Key Facts

Study Design

systematic review — The study only includes randomised studies. Some compare intervention to control patients and others to patients treated with medical therapy. Some studies comparing two interventions are also included.

Number of Patients:

749


Includes an economic evaluation

no

Evidence ratings

Level of evidence

I

Risk of bias
Low risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: systematic review

Studies included in the review
Was an adequate search strategy used?
Very thorough – included appropriate search terms and databases
Were the inclusion criteria appropriate and applied in an unbiased way?
Yes – pre-specified inclusion criteria applied independently by two people
Were the studies assessed for quality (relating to the minimisation of biases)?
Yes – appropriate quality issues were assessed independently by two people
Were the characteristics and results of individual studies appropriately summarised?
Yes – summary descriptive tables of subjects, interventions, outcomes etc are provided and estimates of treatment effect displayed
The following questions are only relevant for systematic reviews that pooled data
Were the methods used for pooling the data appropriate?
Yes
If there was heterogeneity, were sources of heterogeneity explored?
No heterogeneity
Size of effect
2 Reason for decision: The treatment effects that were compared statistically have confidence intervals that cross one in 2 or 3 papers use in one analysis and in 2 out of 2 studies in another analysis. To draw meaningful conclusions from these comparisons is limited.
Relevance of evidence
2 Additional comments: The authors conclude that the various treatments can reliably ablate Barrett's mucosa but that relevant outcomes for the patient have not been established and that the included studies lack statistical power.
Result of appraisal

Jutta's tick icon.png Included



Comments

This review includes some of the papers that I have been asked to review as individual papers and therefore there is duplication of data in the analaysis.

Completed by

Dr Mark Schoeman MBBS, PhD, FRACP, AGAF


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


Article
Li YM, Li L, Yu CH, Liu YS, Xu CF. A systematic review and meta-analysis of the treatment for Barrett's esophagus. Dig Dis Sci 2008 Nov;53(11):2837-46 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18427992.
Assigned to
User:Mark.schoeman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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