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Postoperative adjuvant chemotherapy of gastric cancer: scrutiny into the clinical evidence based on quality assessment of medical literature of randomized controlled trials

Authors
 Hei-Cheul Jeung  ;  Sun Young Rha  ;  Sang Joon Shin  ;  Joong Bae Ahn  ;  Jae Kyung Roh  ;  Chan Hee Park  ;  Sung Hoon Noh  ;  Hyun Cheol Chung 
Citation
 CANCER CHEMOTHERAPY AND PHARMACOLOGY, Vol.63(5) : 919-927, 2009 
Journal Title
CANCER CHEMOTHERAPY AND PHARMACOLOGY
ISSN
 0344-5704 
Issue Date
2009
MeSH
Adenocarcinoma/drug therapy* ; Chemotherapy, Adjuvant ; Databases, Factual ; Evidence-Based Medicine ; Humans ; Postoperative Period ; Quality Assurance, Health Care ; Randomized Controlled Trials as Topic ; Stomach Neoplasms/drug therapy*
Keywords
Adjuvant chemotherapy ; Gastric adenocarcinoma ; Information retrieval ; Randomized controlled trial ; Quality assessment
Abstract
The aim of this study was to scrutinize the evidence of adjuvant chemotherapy of gastric cancer by assessing the quality of the medical literature of randomized controlled trials (RCTs). A quality assessment (QA) scoring system was devised with the three parameters-control of bias, quality of report, and quality of design-which consisted 19 items. We searched for all the publications of the RCTs, from 1969 to 2007, with surgery-only arm, and their associated meta-analyses to score. Among the 26 RCTs, quality of three articles were graded as (2+), 10 articles as (1+), and 13 articles as (-). Recently published studies had overall better quality of report, but not necessarily better quality of design. Three studies demonstrating a positive survival benefit of adjuvant chemotherapy had a grade (1+). Hierarchical clustering revealed that the 26 articles were grouped into three major branches associated with study quality and a multi-institutional setting. We also obtained a statistically significant set of ten items (P < 0.001) that could differentiate articles of good (1-2+) and low quality (-) through supervised two-way hierarchical clustering. Finally, the level of recommendation for adjuvant chemotherapy in gastric cancer was to be a "B" according to the Scottish Intercollegiate Guidelines Network (SIGN) System. QA of medical literature should be an essential consideration for medical-related decision-making and the formation of evidence-based guidelines. Multidisciplinary discussion to develop and refine trial design is important for procuring better quality of RCTs of adjuvant chemotherapy of gastric cancer
Full Text
http://link.springer.com/article/10.1007%2Fs00280-008-0808-5
DOI
10.1007/s00280-008-0808-5
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Roh, Jae Kyung(노재경)
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, Chan Hee(박찬희)
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Jeung, Hei Cheul(정희철) ORCID logo https://orcid.org/0000-0003-0952-3679
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103613
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