Table 5.1Intensive Follow up versus less intensive or no follow up

Quality assessmentSummary of findingsImportance
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsintensive follow upless intensive or no follow upOdds Ratio (95% CI)
Overall survival at 5 years Jeffery et al 2007 (follow-up mean 5 years)
6randomised trialsserious1no serious inconsistencyno serious indirectnessno serious imprecisionnone218/793
(27.5%)
274/808 (33.9%)OR 0.73
(0.59 to 0.91)
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MODERATE
CRITICAL
33.9%
overall survival at 5 years Tjandra 2007 (follow-up mean 5 years)
8randomised trialsserious1no serious inconsistencyno serious indirectnessno serious imprecisionnone321/1474
(21.8%)
373/1449 (25.7%)OR 0.74
(0.59 to 0.93)
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MODERATE
CRITICAL
25.7%
no of recurrences Jeffery 2007 (follow-up mean 5 years)
7randomised trialsserious1no serious inconsistencyno serious indirectnessno serious imprecisionnone354/985
(35.9%)
351/953 (36.8%)OR 0.91
(0.75 to 1.1)
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MODERATE
CRITICAL
36.8%
no of recurrences (all site) Tjandra 2007 (follow-up mean 5 years)
8randomised trialsserious1no serious inconsistency2no serious indirectnessno serious imprecisionnone429/1474
(29.1%)
417/1449 (28.8%)OR 0.97
(0.82 to 1.14)
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MODERATE
CRITICAL
28.8%
no of asymptomatic recurrences Tjandra 2007 (follow-up mean 5 years)
6randomised trialsserious1no serious inconsistencyno serious indirectnessserious3none162/858
(18.9%)
52/821 (6.3%)OR 3.42
(2.17 to 5.41)
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LOW
CRITICAL
6.3%
curative surgery attempted for recurrence Jeffery 2007 (follow-up mean 5 years)
6randomised trialsserious1no serious inconsistencyno serious indirectnessserious3none95/818
(11.6%)
40/795 (5%)OR 2.41
(1.63 to 3.54)
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LOW
CRITICAL
5%
curative surgery attempted for recurrence Tjandra 2007 (follow-up mean 5 years)
7randomised trialsserious1no serious inconsistencyno serious indirectnessserious3none86/354
(24.3%)
35/353 (9.9%)OR 2.81
(1.65 to 4.79)
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LOW
CRITICAL
9.9%
disease specific survival Jeffery 2007 (follow-up mean 5 years)
2randomised trialsserious1no serious inconsistencyno serious indirectnessserious3,6none73/343
(21.3%)
82/361 (22.7%)OR 0.92
(0.64 to 1.31)
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LOW
CRITICAL
22.7%
1

the majority of studies in this comparison had unclear reporting of allocation concealment. This could introduce significant bias to the randomisation process and the results overall.

2

heterogeneity not reported

3

The total number of event is low (less than the 300 rule of thumb). This can introduce imprecision to the result.

4

heterogeneity: p=0.00002, I squared=91%, all 3 studies favour intensive follow up.

5

heterogeneity: p<0.00001, I squared not given, 4 out of 5 studies favour intensive follow up.

6

The CI includes 1 and the lower limit is <than 0.75 and the upper limit is > 1.25

the majority of studies in this comparison had unclear reporting of allocation concealment. This could introduce significant bias to the randomisation process and the results overall.

heterogeneity not reported

The total number of event is low (less than the 300 rule of thumb). This can introduce imprecision to the result.

The CI includes 1 and the lower limit is <than 0.75 and the upper limit is > 1.25

From: 5, Ongoing Care and Support

Cover of Colorectal Cancer
Colorectal Cancer: The Diagnosis and Management of Colorectal Cancer.
NICE Clinical Guidelines, No. 131.
National Collaborating Centre for Cancer (UK).
Copyright © 2011, National Collaborating Centre for Cancer.

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