Critical appraisal:Thrift AP, Kendall BJ, Pandeya N, Vaughan TL, Whiteman DC, Study of Digestive Health 2012

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Critical Appraisal

Article being appraised

Thrift AP, Kendall BJ, Pandeya N, Vaughan TL, Whiteman DC, Study of Digestive Health. A clinical risk prediction model for Barrett esophagus. Cancer Prev Res (Phila) 2012 Sep;5(9):1115-23 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22787114.


Applicable clinical question

Key Facts

Study Design

case-control study

Number of Patients:

285


Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
High risk of bias Comments: Although the summary evidence rating is low, this is a high-quality observational epidemiological study. The low score reflects lack of information about

Risk of bias assessment: case-control study

Subject selection
Cases
Representative of eligible patients (e.g. population-based cancer registry)
Adequacy of case definition
Independent validation of outcome (blind to exposure status)
Controls
From same population as cases and same exclusion criteria used
Comparability of groups on demographic characteristics and important potential confounders
Comparable (or matched)
Ascertainment of exposure/treatment
No or not described
Follow-up complete and all patients included in the analysis?
Low response rate (<80%), non-responders not described, differential response in cases/controls, or no details provided
Size of effect
1 Reason for decision: Risk factor Adjusted OR (95% CI)



AgePer 5 y 1.14 (1.06–1.23)


Sex
Women 1.00 (Ref)
Men 2.17 (1.50–3.14)


Smoking status
Never smoker 1.00 (Ref)
Ex-smoker 1.41 (0.96–2.06)
Current smoker 1.93 (1.15–3.24)


Body mass index last year (kg/m2)
< 25 1.00 (Ref)
25–29.9 0.96 (0.64–1.44)
< 30 1.41 (0.90–2.22)


Highest level of education
University 1.00 (Ref)
Technical college/diploma 1.29 (0.77–2.15)
School only 2.08 (1.23–3.50)


Frequency of use of acid suppressant medications (H2Rs or PPIs) in the past 5 y
Never 1.00 (Ref)
Ever 2.07 (1.46–2.93)


AUC (95%CI)
Development dataset 0.70 (0.66–0.74)
Validation dataset 0.61 (0.56–0.66

Relevance of evidence
1 Additional comments: This study developed a model for predicting the risk of Barrett's esophagus using a pool of clinical and demographic factors. The outcomes were determined appropriately, and the exposures studied are very relevant to patients and persons-at-risk.
Result of appraisal

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Completed by

David Whiteman


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Article
Thrift AP, Kendall BJ, Pandeya N, Vaughan TL, Whiteman DC, Study of Digestive Health. A clinical risk prediction model for Barrett esophagus. Cancer Prev Res (Phila) 2012 Sep;5(9):1115-23 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22787114.
Assigned to
User:David.whiteman
Topic area
Guidelines:Barrett's/Natural history
Clinical question
Form
Form:Critical appraisal


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