Critical appraisal:Simon SR, Zhang F, Soumerai SB, Ensroth A, Bernstein L, Fletcher RH, et al 2010

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Critical Appraisal

Article being appraised

Simon SR, Zhang F, Soumerai SB, Ensroth A, Bernstein L, Fletcher RH, et al. Failure of automated telephone outreach with speech recognition to improve colorectal cancer screening: a randomized controlled trial. Arch Intern Med 2010 Feb 8;170(3):264-70 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20142572.


Applicable clinical question

Key Facts

Study Design

randomised controlled trial

Study aims:

To assess whether an automated telephone outreach with speech recognition can increase the colorectal screening rate

Number of Patients:

20938

50 to 64 year old men and women from a health plan
Reported outcome(s):

Screening for colorectal cancer within 12 months of the intervention

Results of outcome(s):

30.6% screened from the intervention groups vs 30.4% in usual care p=0.76
If consider colonoscopy screening only 21.4% for intervention vs 20.3% p=0.04 with a small effects odds of colonoscopy for intervention 1.01 (95% CI 0.96-1.00)

Comments on results:

Less than 40% of targeted individuals reached

Includes an economic evaluation

no

Evidence ratings

Level of evidence

II

Risk of bias
High risk of bias Comments: no bliniding

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?
No concealment or unclear (e.g. no approach described, open randomisation lists, person doing recruitment tossing a coin).
Were all randomised participants included in the analysis?
Too many exclusions, differential loss in comparison groups, or not reported.
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: CI does not cross unity for colonoscopy
Relevance of evidence
5 Additional comments: negative study so no effect
Result of appraisal

Jutta's tick icon.png Included




Completed by

Prof Ian Olver AM


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Article
Simon SR, Zhang F, Soumerai SB, Ensroth A, Bernstein L, Fletcher RH, et al. Failure of automated telephone outreach with speech recognition to improve colorectal cancer screening: a randomized controlled trial. Arch Intern Med 2010 Feb 8;170(3):264-70 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20142572.
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