Critical appraisal:Menon D, Stafinski T, Wu H, Lau D, Wong C 2010 2

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Critical Appraisal

Article being appraised

Menon D, Stafinski T, Wu H, Lau D, Wong C. Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy. BMC Gastroenterol 2010 Sep 27;10:111 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20875123.


Applicable clinical question

Key Facts

Study Design

systematic review — randomised studies only assessing techniques of Barrett's ablation. No randomised studies assessing Surgery compared with endotherapy. 101 studies assessed. 12 comparative studies defined. Quality of the evidence is low. Offer a summary of the literature comparing safety and effectiveness of endotherapy and resection. Looks at the various techniques of Barrett's ablation. Conclusions: Endotherapy viable and effective. Safer than surgery. no long term data; data on frequency of surveillance; patient preference studies; quality of life after different endotherapies.

Number of Patients:

3042


Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias
Low risk of bias Comments: recommendations made as above.

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?
Some attempt was made
Size of effect
2 Reason for decision: comments made relevant to the two interventions - surgery and endotherapy
Result of appraisal

Jutta's tick icon.png Included




Completed by

Associate Professor Bernard Mark Smithers


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


Article
Menon D, Stafinski T, Wu H, Lau D, Wong C. Endoscopic treatments for Barrett's esophagus: a systematic review of safety and effectiveness compared to esophagectomy. BMC Gastroenterol 2010 Sep 27;10:111 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20875123.
Assigned to
User:Bernard.smithers
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

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