Critical appraisal:Richardson A, Williams S, Elwood M, Bahr M, Medlicott T 1994

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Critical Appraisal

Article being appraised

Richardson A, Williams S, Elwood M, Bahr M, Medlicott T. Participation in breast cancer screening: randomised controlled trials of doctors' letters and of telephone reminders. Aust J Public Health 1994 Sep;18(3):290-2 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/7841259.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Study aims:

To ascertain whether a GPs supporting letter increases breast screening uptake

Number of Patients:

641

50 to 64 year old women eligible for screening form a large urban general practice
Reported outcome(s):

Increase in screening uptake

Results of outcome(s):

Study 1 71% with GP letter vs 64% without p=0.059
With GP letter 56% screened without 43% p=0.01
Fewer with GP letter declined screening p= 0.048
In a second study there was no difference between telephone and letter reminders

Comments on results:

Telephone reminders took more time

Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
Low risk of bias Comments: Definitive results

Risk of bias assessment: randomised controlled trial

Was the trial double-blinded?
I am reasonably certain that the trial was double-blinded (eg identical placebo, active placebo, double-dummy, no revealing side-effects).
Was the treatment allocation schedule concealed?
Adequately concealed (e.g. central randomisation, numbered or coded bottles, drugs prepared by pharmacy).
Were all randomised participants included in the analysis?
No exclusions or survival analysis used with all subjects included (>95% follow-up for all groups).
The field below is not considered when calculating the risk of bias rating
How was the allocation schedule generated?
Adequate (e.g. random number table, computer random generator, coin tossing, card shuffling)
Size of effect
3 Reason for decision: Some definitive P values <0.05
Relevance of evidence
2 Additional comments: Shows some difference with GP letter and no difference between reminder methods and has power to be definitive
Result of appraisal

Jutta's tick icon.png Included




Completed by

Prof Ian Olver AM


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


Article
Richardson A, Williams S, Elwood M, Bahr M, Medlicott T. Participation in breast cancer screening: randomised controlled trials of doctors' letters and of telephone reminders. Aust J Public Health 1994 Sep;18(3):290-2 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/7841259.
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