1 / 20

A systematic review of the validity of endoscopic ultrasound for rectal carcinoma staging

A systematic review of the validity of endoscopic ultrasound for rectal carcinoma staging. Adília Rafael, Agostinho Cordeiro, Alberto Lourenço, Alexandre Sarmento, Ana Isabel Ponte, Beatriz Noronha, Carolina Afonso, Catarina Gomes, Catarina Pedrosa, Cristina Duque Class 1

caraf
Download Presentation

A systematic review of the validity of endoscopic ultrasound for rectal carcinoma staging

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A systematic review of the validity of endoscopic ultrasound for rectal carcinoma staging Adília Rafael, Agostinho Cordeiro, Alberto Lourenço, Alexandre Sarmento, Ana Isabel Ponte, Beatriz Noronha, Carolina Afonso, Catarina Gomes, Catarina Pedrosa, Cristina Duque Class 1 Supervisor: Mário Dinis Ribeiro Introduction to Medicine Porto Faculty of Medicine

  2. Index 1) Introduction 2) Objective 3) Material and Methods 3.1) Study Design 3.2) Inclusion Criteria 3.3) Bibliographic research 3.4) Exclusion criteria 3.5) Methodological quality 3.6) Data extraction 4) Planning

  3. Introduction • Rectal cancer is the most lethal type of cancer within the Portuguese population.(ref) • Its treatment depends on correct staging, and endoscopic ultrasound is one of the methods which makes it possible. • It may be used either to determine candidacy for surgery or as a surveillance method after surgery, because the recurrence of local tumors is quite common. Lightdale, C. J., Advances in Endoscopic ultrassound: 13th International Symposium, Gastrointestinal endoscopy Vol 56, nº 4 (suppl), 2002

  4. Introduction • Rectal cancer is staged using the Tumor-Node-Metastasis (TNM) staging system. According to the EUS stage, the management of the cancer is also different: Lightdale, C. J., Advances in Endoscopic ultrassound: 13th International Symposium, Gastrointestinal endoscopy Vol 56, nº 4 (suppl), 2002

  5. Introduction

  6. Objective We aimed at analyzing the validity and consistency of EUS for rectal carcinoma staging in relation to surgical specimens. N

  7. Material and Methods Study Design: Systematic Review Inclusion Criteria: • The selected articles should describe studies designed to evaluate the accuracy of endoscopic ultrasound (EUS) in rectal carcinoma staging. • The accuracy of EUS should be evaluated in a sample of patients with rectal carcinoma. • The results of the application of EUS should be compared to the surgical specimen (gold standard).

  8. Material and Methods Bibliographic Research: According to the inclusion criteria, a bibliographic research was carried out in Medline using the following query: (((((((((("sensitivity and specificity"[All Fields] OR "sensitivity and specificity/standards"[All Fields]) OR "specificity"[All Fields]) OR "screening"[All Fields]) OR "false positive"[All Fields]) OR "false negative"[All Fields]) OR "accuracy"[All Fields]) OR (((("predictive value"[All Fields] OR "predictive value of tests"[All Fields]) OR "predictive value of tests/standards"[All Fields]) OR "predictive values"[All Fields]) OR "predictive values of tests"[All Fields])) OR (("reference value"[All Fields] OR "reference values"[All Fields]) OR"reference values/standards"[All Fields])) OR ((((((((((("roc"[All Fields] OR "roc analyses"[All Fields]) OR "roc analysis"[All Fields]) OR "roc and"[All Fields]) OR "roc area"[All Fields]) OR "roc auc"[All Fields]) OR "roc characteristics"[All Fields]) OR "roc curve"[All Fields]) OR "roc curve method"[All Fields]) OR "roc curves"[All Fields]) OR "roc estimated"[All Fields]) OR "roc evaluation"[All Fields])) OR "likelihood ratio"[All Fields]) AND ("Endosonography"[MeSH]AND ("Rectal neoplasms"[MeSH] OR "Colorectal neoplasms"[MeSH]))

  9. Material and Methods • This query was based on a search strategy in PubMed (MEDLINE) for publications about the evaluation of diagnostic accuracy, suggested by a research article (Devillé, W. L. et. al., Conducting systematic reviews of diagnostic studies: didactic guidelines). • The research was limited to “items with abstracts” and items referring to “humans”. • 131 abstracts were obtained.

  10. Material and Methods Exclusion Criteria: • Articles written in languages other than English, French or Spanish. • Articles not evaluating diagnostic tests. • Articles evaluating the accuracy of EUS in staging of other cancers rather than rectal carcinoma.

  11. Material and Methods Exclusion Criteria for full papers: • The article does not allow the construction of a 2x2 table (T & N both for EUS and surgical specimen). • The paper is not available at the Porto Faculty of Medicine library (or IPO), in the World Wide Web or other possible sources.

  12. Material and Methods • The articles obtained in the bibliographic research were distributed to 5 groups of 2 elements each. • A third element, the supervisor, was consulted in case of disagreement. • Attending to the criteria defined, 68 articles were selected.

  13. Material and Methods Methodological Quality: • Each article will be submitted to evaluation by two reviewers that independently will grade them as far as quality is concerned. • Disagreements will be solved by consensus or arbitration (by the supervisor). • This stage will be based on the Standard for Reporting of Diagnostic Accuracy (STARD) checklist (Bossuyt, P. M. et. al., Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative, Annals of Internal Medicine Vol 138 – nº1, 7 January 2003).

  14. Material and Methods STARD checklist

  15. Material and Methods Bossuyt, P. M. et. al., Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative, Annals of Internal Medicine Vol 138 – nº1, 7 January 2003

  16. Material and Methods Data Extraction: • Those two reviewers will also independently extract the required information from the primary studies. • Disagreements should, in the same way as before, be recorded and resolved by consensus or arbitration. • The data should be extracted using a standardised extraction form. Details will be requested from the authors of the studies.

  17. Material and Methods • Data to be extracted: • Procedure; • Year of procedures included in the study; • Instrument (Pentax, Olympus; frequency 7.5 versus 12 versus 20 MHz); • Instrument (flexible/rigid); • Operator (single versus several; number of procedures per year); • Reference (year/changes in cancer classification TNM); • Lesion (stenotic lesions; location upper/lower rectum- exclude anal)

  18. Material and Methods • Sensitivity and specificity per article will be calculated based on the 2x2 tables. • Homogeneity will be assessed and pooled results estimated if possible.

  19. Planning

  20. Planning

More Related