Critical appraisal:Paul S, Isaacs AJ, Treasure T, Altorki NK, Sedrakyan A 2014

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Critical Appraisal

Article being appraised

Paul S, Isaacs AJ, Treasure T, Altorki NK, Sedrakyan A. Long term survival with thoracoscopic versus open lobectomy: propensity matched comparative analysis using SEER-Medicare database. BMJ 2014 Oct 2;349:g5575 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25277994.


Applicable clinical question

Key Facts

Study Design

case-control study

Study aims:

To assess the influence of less invasive thoracoscopic surgery on overall survival, disease-free survival, and cancer specific survival

Number of Patients:

2390

SEER database
Reported outcome(s):

Overall survival
Disease-free survival
Cancer specific survival
(All 3 year)

Results of outcome(s):

Overall survival was no different between VATS and thoracotomy; 70.6% v 68.1%, P=0.55
Disease-free survival was no different between VATS and thoracotomy; 86.2% v 85.4%, P=0.46
Cancer specific survival was no different between VATS and thoracotomy; 92% v 89.5%, P=0.05

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias
Moderate risk of bias Comments: Largest database in existence and taken over short, relevant timespan. Upgrade to medium

Risk of bias assessment: case-control study

Subject selection
Cases
Representative of eligible patients (e.g. population-based cancer registry)
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?
Complete response
Size of effect
3 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
1 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

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Completed by

Associate Professor Gavin Wright MD FRACS PhD


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Article
Paul S, Isaacs AJ, Treasure T, Altorki NK, Sedrakyan A. Long term survival with thoracoscopic versus open lobectomy: propensity matched comparative analysis using SEER-Medicare database. BMJ 2014 Oct 2;349:g5575 Available from: http://www.ncbi.nlm.nih.gov/pubmed/25277994.
Assigned to
User:Gavin.wright
Topic area
Guidelines:Lung cancer/Treatment/Non-small-cell stage I operable
Clinical question
Form
Form:Critical appraisal


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