Critical appraisal:Sharma P, Wani S, Weston AP, Bansal A, Hall M, Mathur S, et al 2006

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Critical Appraisal

Article being appraised

Sharma P, Wani S, Weston AP, Bansal A, Hall M, Mathur S, et al. A randomised controlled trial of ablation of Barrett's oesophagus with multipolar electrocoagulation versus argon plasma coagulation in combination with acid suppression: long term results. Gut 2006 Sep;55(9):1233-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16905695.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial — The patients were randomised to one of two treatment arms. There was no control group. The randomisation was good using sealed opaque envelopes.

Number of Patients:

35


Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
High risk of bias Comments: The treatment and outcome of the study was not blinded.

Risk of bias assessment: randomised controlled trial

Was the trial double-blinded?
Outcomes not blinded, substantial side-effects, or not reported.
Was the treatment allocation schedule concealed?
Inadequately concealed (e.g. numbered/sealed envelopes, alternation, medical record number, date of birth).
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?
Inadequate or not reported
Size of effect
2 Reason for decision: APC and MPEC are able to ablate Barrett's mucosa with minimal complications. In those who were successfully ablated the effect was durable for the 2 year follow period. No patients lost to follow up
Relevance of evidence
2 Additional comments: The study compares two treatment arms and shows no difference in outcome. There is no control arm. The study was performed in non-dysplastic Barrett's mucosa and patient outcome in this group of patients is uncertain. The intervention is reliably able to ablate Barrett's mucosa.
Result of appraisal

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Completed by

Dr Mark Schoeman MBBS, PhD, FRACP, AGAF


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Article
Sharma P, Wani S, Weston AP, Bansal A, Hall M, Mathur S, et al. A randomised controlled trial of ablation of Barrett's oesophagus with multipolar electrocoagulation versus argon plasma coagulation in combination with acid suppression: long term results. Gut 2006 Sep;55(9):1233-9 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/16905695.
Assigned to
User:Mark.schoeman
Topic area
Guidelines:Barrett's
Clinical question
Form
Form:Critical appraisal


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