Department of Anesthesiology

JOURNAL REPORTING

BY: JESSA ANJELICA AQUINO M.D.

OUTLINE

 Objectives
 Journal Search
 Appraising Directness
 Appraising Validity
 Interpreting Results
 Assessing Applicability
OBJECTIVES

To be able to evaluate the directness, validity, and results

To be able to evaluate the applicability of the treatment
plan in correlation to the case
CLINICAL DILEMMA

 Is there a difference in Volatile versus Total Intravenous Anesthesia for Cancer

Prognosia in Patients that will undergo digestive cancer surgery?
Department of Anesthesiology

BY: JESSA ANJELICA AQUINO M.D.

CRITICAL APPRAISAL

Are the results valid?

What are the results?
Will they help me care of my patients?
A. ARE THE RESULTS VALID?

 1. Was there a clear question for this study to address?

Clinical Scenario Clinical Question Journal

Population Patients with Cancer Adult >18 yo; who had
elective surgery
Intervention Volatile and Intravenous Volatile and Intravenous
Anesthesia Anesthesia
Outcome Mortality and morbidity Mortality status
A. ARE THE RESULTS VALID?

 II. Was there a comparison with an appropriate reference standard? Yes

 Methods: The authors selected patients who had elective esophagectomy, gastrectomy, hepatectomy,
cholecystectomy, pancreatectomy, colectomy, and rectal cancer surgery from July 2010 to March 2018 using the
Japanese Diagnosis Procedure Combination database.
A. ARE THE RESULTS VALID?

 III. Did all patients get the treatment test and the reference standard? YES

Volatile Anesthesia

Intravenous Anesthesia
A. ARE THE RESULTS VALID?

 IV. Could the results of the test of interest have been influenced by the results of the reference standard?
 Was there blinding? YES
 V. Is the disease status clearly described?
 VI. Were the methods for performing the test described in sufficient detail?
 RESULTS

 What are the results?

 There were no significant differences between the
two groups in overall survival whereas instrumental
variable analyses showed a slight difference in
recurrence-free survival (hazard ratio, 0.92; 95%
CI, 0.87 to 0.98; P = 0.01). Subgroup analyses
showed no significant difference in overall or
recurrence-free survival between the groups in any
type of surgery.
 VIII. How sure are we about these results?
 - No confidence limit was mentioned in the study
 IX. Can the results be applied to your patients / population of interest?
 - the population mentioned in the study has the criteria similarly with the patient
considering the age and comorbidity of the patient.
 However, considering the age >18 yo, with particular diseases were used in the study
which may cause bias in the study.
WILL THEY HELP ME CARE OF MY PATIENT?

 X. Can the test be applied?

 For the resources and outcome there’s no significant difference in terms of cost.
 Current practice and availability of services.
 CONCLUSION

-This article was valid

-Overall and recurrence-free survival were similar between volatile and intravenous
anesthesia in patients having digestive tract surgery. Selection of the anesthetic approach
for these patients should be based on other factors.
 Thank you 