A meta-analysis of endoscopic variceal ligation for primary prophylaxis of esophageal variceal bleeding

CRD COMMENTARY:

The aims were stated and the inclusion criteria were defined in terms of study design, interventions, participants and outcomes. Several relevant sources were searched and the keywords used were reported. In addition, attempts were made to locate unpublished material and publication bias was assessed. The methods used to select the studies were described. Validity was assessed and scored using defined criteria, and the methods used to assess the validity were reported. Relevant data were presented in tabular format, and details were given of the methods used to extract the data.
Clinical heterogeneity among studies was discussed and statistical heterogeneity was assessed. A meta-analysis was appropriate given the evidence of clinical and statistical homogeneity. The results from abstracts and studies published in full were compared. However, there was a discrepancy in the results reported for bleed-related mortality: the reported RR for abstracts (0.17) appears to be in error since it lies outside of the confidence range.
The evidence presented supports the authors' conclusion.