Critical appraisal:Reid BJ, Levine DS, Longton G, Blount PL, Rabinovitch PS 2000 5

From Cancer Guidelines Wiki

Critical Appraisal

Article being appraised

Reid BJ, Levine DS, Longton G, Blount PL, Rabinovitch PS. Predictors of progression to cancer in Barrett's esophagus: baseline histology and flow cytometry identify low- and high-risk patient subsets. Am J Gastroenterol 2000 Jul;95(7):1669-76 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/10925966.


Applicable clinical question

Key Facts

Study Design

prevalence and incidence study

Number of Patients:

322


Includes an economic evaluation

no

Evidence ratings

Risk of bias
High risk of bias Comments: This single institution prevalence and incidence study (prospective cohort) followed-up patients for relevant endpoints including HGD and adenocarcinoma.

Exposure information included flow cytometry conducted on baseline biopsy specimens, as well as histological assessments of dysplasia.

Risk of bias assessment: prevalence and incidence study

Source population of patients
Highly selected (single institution) or not described
Subject (sample) selection
Highly selected (selection at clinician's discretion regardless of whether sample consecutive), unclear or not described
Measurement of condition
Objective and reliable (based on registry or other equivalent source)
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Result of appraisal

Jutta's tick icon.png Included



Comments

Cumulative incidence of cancer in negative patients @ 5 yrs = 1.7% (0.2-11)
Cumulative incidence of cancer in IND dysplasia patients @ 5 yrs = 3.0% (0.5-20)
Cumulative incidence of cancer in LGD patients @ 5 yrs = 12% (4-34)
Cumulative incidence of cancer in HGD patients @ 5 yrs = 59% (1.6-9)

RR of cancer in aneuploidy or 4N patients = 11 (5.5-21)

Completed by

David Whiteman


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


Article
Reid BJ, Levine DS, Longton G, Blount PL, Rabinovitch PS. Predictors of progression to cancer in Barrett's esophagus: baseline histology and flow cytometry identify low- and high-risk patient subsets. Am J Gastroenterol 2000 Jul;95(7):1669-76 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/10925966.
Assigned to
User:Philip.craig
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


Section below only relevant for Cancer Council Project Officer

Edit appraisal assignment