Critical appraisal:Roberts KJ, Harper E, Alderson D, Hallissey M 2010

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Critical Appraisal

Article being appraised

Roberts KJ, Harper E, Alderson D, Hallissey M. Long-term survival and cost analysis of an annual Barrett's surveillance programme. Eur J Gastroenterol Hepatol 2010 Apr;22(4):399-403 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19858726.


Applicable clinical question

Key Facts

Study Design

health economic study

Number of Patients:

302


Includes an economic evaluation

yes

Evidence ratings

Level of evidence

IV


Risk of bias assessment: health economic study

Study design
The research question is stated
Yes
The economic importance of the research question is stated
Yes
The viewpoint(s) of the analysis are clearly stated and justified
No response
The rationale for choosing alternative programmes or interventions compared is stated
No
The alternatives being compared are clearly described
Yes
The form of economic evaluation used is stated
Yes
The choice of form of economic evaluation is justified in relation to the questions addressed
Yes
Data collection
The source(s) of effectiveness estimates used are stated
Yes
Details of the design and results of effectiveness study are given (if based on a single study)
Yes
Details of the methods of synthesis or meta-analysis of estimates are given (if based on a synthesis of a number of effectiveness studies)
Not appropriate
The primary outcome measure(s) for the economic evaluation are clearly stated
Yes
Methods to value benefits are stated
Not appropriate
Details of the subjects from whom valuations were obtained were given
Not appropriate
Productivity changes (if included) are reported separately
Not appropriate
The relevance of productivity changes to the study question is discussed
Not appropriate
Quantities of resource use are reported separately from their unit costs
No
Methods for the estimation of quantities and unit costs are described
Yes
Currency and price data are recorded
Yes
Details of currency of price adjustments for inflation or currency conversion are given
Yes
Details of any model used are given
Not appropriate
The choice of model used and the key parameters on which it is based are justified
Not appropriate
Analysis and interpretation of results
Time horizon of costs and benefits is stated
Yes
The discount rate(s) is stated
No
The choice of discount rate(s) is justified
No
An explanation is given if costs and benefits are not discounted
No
Details of statistical tests and confidence intervals are given for stochastic data
Yes
The approach to sensitivity analysis is given
No
The choice of variables for sensitivity analysis is justified
No
The range over which the variables are varied is justified
No
Relevant alternatives are compared
Yes
Incremental analysis is reported
Yes
Major outcomes are presented in a desegregated as well as aggregated form
Yes
The answer to the study question is given
Yes
Conclusions follow from the data reported
Not clear
Conclusions are accompanied by the appropriate caveats
Not clear
Size of effect
5 Reason for decision: Not really applicable to health economic studies
Relevance of evidence
6 Additional comments: Levels of evidence rankings are not clear for health economic studies. This study has a different comparator (i.e., prevalent cases of cancer) compared with all other studies in this topic where 'no surveillance' is normally and appropriately used. The inference to cost-effectiveness is therefore questionable.
Result of appraisal

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Completed by

Dr Louisa Gordon


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Article
Roberts KJ, Harper E, Alderson D, Hallissey M. Long-term survival and cost analysis of an annual Barrett's surveillance programme. Eur J Gastroenterol Hepatol 2010 Apr;22(4):399-403 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/19858726.
Assigned to
User:Louisa.gordon
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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