Critical appraisal:Pastorino U, Rossi M, Rosato V, Marchianò A, Sverzellati N, Morosi C, et al 2012
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Critical Appraisal
Article being appraised
Pastorino U, Rossi M, Rosato V, Marchianò A, Sverzellati N, Morosi C, et al. Annual or biennial CT screening versus observation in heavy smokers: 5-year results of the MILD trial. Eur J Cancer Prev 2012 May;21(3):308-15 Available from: http://www.ncbi.nlm.nih.gov/pubmed/22465911.
Applicable clinical question
Key Facts
Study Design
randomised controlled trial
Number of Patients:
4099
Includes an economic evaluation
no
Evidence ratings
Level of evidence
II
Risk of bias
Moderate risk of bias | Comments: |
Size of effect
4 | Reason for decision: Both lung cancer specific mortality rates and total mortality rates between control, biennial and annual LDCT screening did not reach a significant difference, with p value of 0.21 and 0.13 respectively. |
Relevance of evidence
1 | Additional comments: lung cancer specific mortality and all causes mortality were both reported. |
Result of appraisal
Comments
Completed by
- Article
- Pastorino U, Rossi M, Rosato V, Marchianò A, Sverzellati N, Morosi C, et al. Annual or biennial CT screening versus observation in heavy smokers: 5-year results of the MILD trial. Eur J Cancer Prev 2012 May;21(3):308-15 Available from: http://www.ncbi.nlm.nih.gov/pubmed/22465911.
- Assigned to
- User:Eddie.lau
- Topic area
- Guidelines:Lung cancer/Screening and early detection
- Clinical question
- Study design
- randomised controlled trial
- Level of Evidence
- II
Section below only relevant for Cancer Council Project Officer
The authors stated that this trial is under powered to detect LDCT screening benefit in the order of 10%.
Other useful information from this trial are 1. Selective use of PET decreases surgery for benign nodules to ~9%. 2. Element of overdiagnosis suggested by the annual versus biennial LDCT data. 3. The early pilot data and mortality curve with 10 years follow up did not suggest a protective effect of long term LDCT screening.