Critical appraisal:Rees JR, Lao-Sirieix P, Wong A, Fitzgerald RC 2010 6

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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 — Only randomised studies were included. The included studies examined an intervention compared with placebo, surveillance or another intervention.

Number of Patients:

Not applicable


Includes an economic evaluation

no

Evidence ratings

Level of evidence

I

Risk of bias
Moderate risk of bias Comments: The study is descriptive and reports the studies individually or grouped if examining the same intervention against a comparable control or other treatment arm. Extraordinary amount of detail in the analysis of the scientific quality of the included studies.

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?
Adequate – inclusion criteria were pre-specified and applied by one person
Were the studies assessed for quality (relating to the minimisation of biases)?
Adequate – some problems with quality issues or assessed by one person only
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
2 Reason for decision: There are various interventions assessed. Some compare to placebo or a medically treated surveillance group whilst other studies compare two or more interventions. Sample sizes vary and the size of the effect is also quite different in the various studies. All interventions results in successful ablation of mucosa to a greater or lesser extent.
Relevance of evidence
2 Additional comments: The included studies are almost entirely conducted in patients with non-dysplastic Barrett's mucosa. The authors conclude that ablation is feasible but the relevance to the ablation of dysplastic mucosa is unclear.
Result of appraisal

Jutta's tick icon.png Included




Completed by

Dr Mark Schoeman MBBS, PhD, FRACP, AGAF


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:Mark.schoeman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

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