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. 2016 Nov 24;2016(11):CD002200. doi: 10.1002/14651858.CD002200.pub3
Methods RCT
Accrual: 2007 to 2011
Median follow‐up: 24 months
Participants 110 participants (65 men and 45 women) surgically treated for colon cancer
Dukes' A: 24
Dukes' B: 55
Dukes' C: 32
Country: Norway
Setting: hospital and community
Interventions Experimental arm: surgeon follow‐up
Control: GP follow‐up
The follow‐up intervals were the same.
Outcomes
  • Quality of life (measured using EORTC QLQ‐C30 and EuroQol‐5D (EuroQol five dimensions questionnaire: EQ‐5D)

  • Cost‐effectiveness

  • Time to cancer diagnosis

Notes National follow‐up guidelines were applied in both study arms, and participants were followed for 2 years.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Quote: "Patients are randomised to follow‐up either by their GP (intervention) or at the surgical clinic (controls)."
Comment: the study did not report a description of the method used to generate randomisation sequence.
Allocation concealment (selection bias) Low risk Quote: "...using a web‐based randomisation service and managed by the Norwegian University of Science and Technology."
Comment: because the study used a web‐based method, we assumed that it was truly concealed.
Blinding of participants and personnel Low risk Quote (page 3): "Recruited patients were not informed about the other patients recruited in the same trial. Similarly, no information regarding trial progress and allocation was revealed to the participating GPs or surgeons. However, as GP‐organised follow‐up represented a new practice, blinding was not possible in the intervention arm."
Comment: we judged this domain to be at low risk of bias.
Blinding of outcome assessment Low risk Quote (page 3): "The local trial investigator was not involved in the subsequent follow‐up appointments in any way."Comment: this indicated that the assessors were blinded to the treatment arm; therefore, we judged this domain to be at a low risk of bias.
Incomplete outcome data (attrition and exclusions) Low risk The study reported no exclusions, but detailed information with respect to attrition (detailed by arm and with reasons given) ensured that we judged this domain to be at low risk of bias.
Selective reporting (reporting bias) Unclear risk Outcomes specified in the objectives
  • EORTC QLQ‐C30

  • EQ‐5D

  • EQ‐VAS

  • Cost‐effectiveness

  • Time to diagnosis of relapse


The paper reported on all of these. We did not have access to the protocol, so judged this outcome to be at unclear risk of bias.
Other sources of bias Unclear risk We detected no other bias.