A more recent meta-analysis of 6 trials (121) found that routine second-look endoscopy, with heater probe therapy when appropriate, significantly reduced the risk for rebleeding (RR, 0.29 [CI, 0.11 to 0.73]) compared with single endoscopy; however, performing second-look endoscopy with injection monotherapy conferred no advantage. A meta-analysis performed for the meeting (23) included 6 trials comprising 750 patients. It excluded 2 older abstracts (117 - 118), which have not been fully published, and Rutgeerts and colleagues' study (114), which included second-look endoscopy in both study groups. In the meta-analysis, routine second-look endoscopy significantly decreased rebleeding (OR, 0.59 [CI, 0.38 to 0.91]) and surgery (OR, 0.43 [CI, 0.19 to 0.96]) but not mortality (OR, 0.65 [CI, 0.26 to 1.62]) (Appendix Table 2). These findings must be interpreted in light of differences across trials with regard to patient selection, adopted methodologies, and both intervention and control treatments, as well as sensitivity analyses that show poor robustness of the results. The most favorable results were from studies with the greatest proportions of high-risk patients (110,113). Indeed, Chiu and colleagues (110) included 47% of patients who presented with shock and more than 40% with active bleeding. Similarly, Saeed and colleagues (113) assessed patients with a very high risk for rebleeding (on the basis of Forrest high-risk stigmata, as well as additional clinical and endoscopic criteria), of whom 70% had active bleeding. Although the investigators reported the noted decrease in rebleeding (OR, 0.08 [CI, 0.00 to 1.50]) as statistically significant in the final results of the latter trial, it did not remain so when conventional 2-sided inferential testing, adapted to the small sample size, was applied.