Critical appraisal:Rees JR, Lao-Sirieix P, Wong A, Fitzgerald RC 2010 3

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Critical Appraisal

Article being appraised

Rees JR, Lao-Sirieix P, Wong A, Fitzgerald RC. Treatment for Barrett's oesophagus. Cochrane Database Syst Rev 2010 Jan 20;(1):CD004060 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20091557.


Applicable clinical question

Key Facts

Study Design

systematic review — randomised

Number of Patients:

1074


Includes an economic evaluation

no

Evidence ratings

Level of evidence

I

Risk of bias
Low risk of bias Comments: did not include any surgical resection, includes all barretts not just high grade dysplasia. Good quality systematic review but not specific to current squestion, provides some evidence on endoscopic options but the rcts are endo versus PPI or nothing or apc versus PDT which are not really applicable to current management options

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?
No response
If there was heterogeneity, were sources of heterogeneity explored?
No response
Size of effect
4 Reason for decision: see summary of findings table only p values and confidence intervals fro PDT versus PPI or rfa vs sham. Confidence intervals wide or not reported form majority, progression to cancer eihter not reported or no difference
Relevance of evidence
2 Additional comments: see above comments, not specific to high grade dysplasia and not compared to surgery
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
Rees JR, Lao-Sirieix P, Wong A, Fitzgerald RC. Treatment for Barrett's oesophagus. Cochrane Database Syst Rev 2010 Jan 20;(1):CD004060 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20091557.
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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