Journal Club Summarybiliary colic

Methodology: 4/5
Usefulness: 2/5

Colli A, Conte D, Valle SD, Sciola V, Fraquelli M.
Aliment Pharmacol Ther. 2012 Jun;35(12):1370-8 
This meta-analysis of 11 RCTs found that in patients with biliary colic, NSAIDs had a higher proportion of complete pain relief compared placebo (RR 3.77, 95%CI 1.65-8.61) and spasmolytics (RR 1.47, 95%CI 1.03-2.10), no difference compared to opioids and less cholelithiasis-related complications compared to placebo or other drugs. This was a well-conducted meta-analysis that followed the 2009 PRISMA guidelines, however the JC attendees agreed the impact is limited due to the significant clinical and statistical heterogeneity between the studies evaluated.  
By: Dr. Adam Nicholson
(Presented March 2013)

Epi lesson:

When reviewing systematic literature reviews, pay attention to how the research question is phrased. High quality studies will follow the PRISMA guidelines’ suggestion to use the PICOS (participants, interventions, comparisons, outcomes, study design) format. A precise research question will guide study selection and should also dictate how table 1 summarizes the included studies.  Having these details will also assist the reader in evaluating the included studies for generalizability and clinical heterogeneity. 
By: Dr. Lisa Calder