Critical appraisal:Schembre DB, Huang JL, Lin OS, Cantone N, Low DE 2008 2

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Critical Appraisal

Article being appraised

Schembre DB, Huang JL, Lin OS, Cantone N, Low DE. Treatment of Barrett's esophagus with early neoplasia: a comparison of endoscopic therapy and esophagectomy. Gastrointest Endosc 2008 Apr;67(4):595-601 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18279860.


Applicable clinical question

Key Facts

Study Design

cohort study

Number of Patients:

94


Includes an economic evaluation

yes

Evidence ratings

Level of evidence

III-2

Risk of bias
High risk of bias Comments: Endo and surgery groups different, follow up in end group only 20 months compared to 48 months in surg group, 13% patients lost ot follow up in endo group. Tried comparing surgical candidates in endo group with surgery group in discussion section but no data

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Selected group
Comparison group
Selected group
Comparability of groups on demographic characteristics and clinical features
Not comparable but adjusted analysis used
Measurement of outcomes
Outcome measures blind to technology used
No, but objective measures used
Same method of measurement used across comparison groups
No or not described
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Reasonable follow-up of all groups (>80%)
Size of effect
3 Reason for decision: No difference in mortality or survival rate, only differences in residual barretts, minor complications and hospital costs.
Relevance of evidence
1 Additional comments: Evidence relevant to question, info on progression to cancer, persistent dysplasia and barrett's, mortality and morbidity given
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
Schembre DB, Huang JL, Lin OS, Cantone N, Low DE. Treatment of Barrett's esophagus with early neoplasia: a comparison of endoscopic therapy and esophagectomy. Gastrointest Endosc 2008 Apr;67(4):595-601 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18279860.
Assigned to
User:Bernard.smithers
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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