Critical appraisal:Shami VM, Villaverde A, Stearns L, Chi KD, Kinney TP, Rogers GB, et al 2006

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Critical Appraisal

Article being appraised

Shami VM, Villaverde A, Stearns L, Chi KD, Kinney TP, Rogers GB, et al. Clinical impact of conventional endosonography and endoscopic ultrasound-guided fine-needle aspiration in the assessment of patients with Barrett's esophagus and high-grade dysplasia or intramucosal carcinoma who have been referred for endoscopic ablation therapy. Endoscopy 2006 Feb;38(2):157-61 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16479423.


Applicable clinical question

Key Facts

Study Design

case series

Number of Patients:

25


Includes an economic evaluation

no

Evidence ratings

Level of evidence

IV

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your quality rating

Risk of bias assessment: case series

Subject selection:
Highly selected or not described (e.g. single-institution study)
Were the outcome measures blind to pre/post-intervention?
No, but objective measures used
Follow-up complete and all patients included in the analysis?
Yes (follow-up >95%)
Size of effect
5 Reason for decision: Please replace this text and briefly describe the reasons for your rating
Relevance of evidence
2 Additional comments: Please replace this text and briefly describe the reasons for your rating
Result of appraisal

Jutta's tick icon.png Included



Comments

This is a prospective, single-institution case series of 25 consecutive patients who underwent EUS with FNA of any suspicious lymph nodes. Five patients were found to have submucosal invasion on conventional endosonography. Seven patients had suspicious adenopathy, six regional (N1) and one metastatic to the celiac axis (M1a). Fine-needle aspiration confirmed malignancy in five of these seven patients. Based on these results, five patients (20%) were deemed to be unsuitable
candidates for endoscopic therapy. The authors concluded that conventional endosonography and endoscopic ultrasound with fine-needle aspiration when nodal disease is present should be performed routinely in all patients referred for endoscopic therapy in this setting.

Completed by

Dr Jeremy Dwyer MBBS (Hons)


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


Article
Shami VM, Villaverde A, Stearns L, Chi KD, Kinney TP, Rogers GB, et al. Clinical impact of conventional endosonography and endoscopic ultrasound-guided fine-needle aspiration in the assessment of patients with Barrett's esophagus and high-grade dysplasia or intramucosal carcinoma who have been referred for endoscopic ablation therapy. Endoscopy 2006 Feb;38(2):157-61 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16479423.
Assigned to
User:Alan.moss
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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