Diagnostic Evaluation of Rectal Bleeding

Overview

Featured Article

Allen E, Nicolaidis C, Helfand M; The Evaluation of Rectal Bleeding in Adults. A cost-effectiveness Analysis Comparing Four Diagnostic Strategies. J Gen Intern Med 2005; 20: 81-90

Expert Reviews:

Methodological Reviewer
Mark Taylor MD, Department of Surgery, University of Manitoba

Clinical Reviewer
George Chang MD, MS, FACS, FASCRS, Department of Surgery, University of Texas, MD Anderson Cancer Center

Clinical Reviewer
Paul Johnson MD, MSc, FRCSC, Department of Surgery, Dalhousie University

Supplementary Articles

Richardson WS, Detsky AS, for the Evidence-Based Medicine Working Group. Users’ Guides to the Medical Literature. VII. How to Use a Clinical Decision Analysis. JAMA 1995;273(16):1292-95

Richardson WS, Detsky AS, for the Evidence-Based Medicine Working Group. Users’ Guides to the Medical Literature. VII. How to Use a Clinical Decision Analysis. JAMA 1995;273(20):1610-13

Questions

Please read the provided articles and be prepared to discuss the following:

  1. What is the clinical question being addressed?
  2. Were all of the realistic clinical strategies compared?
  3. Were all clinically relevant outcomes considered?
  4. Was an explicit and sensible process used to identify, select and combine the evidence into probabilities?
  5. Were the utilities obtained in an explicit and sensible way from credible sources?
  6. Was the potential impact of any uncertainty in the evidence determined in the baseline analysis?
  7. Does one strategy result in a clinically important gain for patients?
  8. How strong is the evidence used in the analysis?
  9. Could the uncertainty in the evidence change the results?
  10. Do the probability estimates fit my patients’ clinical features?
  11. Do the utilities reflect how my patients would value the outcomes of the decision?
  12. State the conclusion. Have the authors addressed the clinical question?
  13. Does the evidence support the conclusion?