jueves, 26 de febrero de 2015

Debe ser utilizado en...

... ensayos clínicos y revisiones sistemáticas.

The International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH)

Referencia
http://www.ich.org/home.html. (Accedado: 26 de febrero de 2015).

miércoles, 25 de febrero de 2015

Para calcular NNT


Visual Rx Version 3 from Dr Chris Cates' EBM Web Site

http://www.nntonline.net/visualrx/

lunes, 23 de febrero de 2015

Las drogas matan...


Referencia:
Lexchin J. Why are there deadly drugs? BMC Med. 2015; 13(1):27. 

domingo, 22 de febrero de 2015

La epidemiología clínica es el sustento de...

...lo invito a disfrutar este clásico. 

Referencia:
Sackett DL. Clinical epidemiology. what, who, and whither. J Clin Epidemiol. 2002; 55(12):1161-6.

Inflación de efectos por...

...inadecuado ocultamiento de la secuencia de la aleatorización.

Referencia:
Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA. 1995; 273(5):408-12.

El riesgo médico

Referencia:
Bogardus ST Jr, Holmboe E, Jekel JF. Perils, pitfalls, and possibilities in talking about medical risk. JAMA. 1999;281(11):1037-41.

sábado, 21 de febrero de 2015

No solo el beneficio clínico...

... me interesan los perjuicios de la medicación. ¡<>!

Referencia:

Mahady SE, Schlub T, Bero L, Moher D, Tovey D, George J, et al. Side effects are incompletely reported among systematicreviews in gastroenterology. J Clin Epidemiol. 2015; 68(2):144-53. 

viernes, 20 de febrero de 2015

<<...basada en la mejor evidencia disponible>>...

... no es sinónimo de evidencia sólida.

Referencias:
1. Brok J, Thorlund K, Gluud C, Wetterslev J. Trial sequential analysis reveals insufficient information size and potentially false positive results in many meta-analyses. Journal of Clinical Epidemiology 2008; 61:763-769.


2. Brok J, Thorlund K, Wetterslev J, Gluud C. Apparently conclusive meta-analyses may be inconclusive - Trial sequential analysis adjustment of random error risk due to repetitive testing of accumulating data in apparently conclusive neonatal meta-analyses. International Journal of Epidemiology 2009; 38:287-298.

3. Thorlund K, Devereaux PJ, Wetterslev J, Guyatt G, Ioannidis JP, Thabane L, et al. Can trial sequential monitoring boundaries reduce spurious inferences from meta-analyses? International Journal of Epidemiology 2009; 38:276-286.

4. Thorlund K, Imberger G, Walsh M, Chu R, Gluud C, Wetterslev J, et al. The number of patients and events required to limit the risk of overestimation of intervention effects in meta-analysis- a simulation study. PLoS One. 2011; 6(10):e25491.

5. Wetterslev J, Thorlund K, Brok J, Gluud C. Trial sequential analysis may establish when firm evidence is reached in cumulative meta-analysis. Journal of Clinical Epidemiology 2008;61:64-75.

Cómo enfrentarse a un paso decisivo...los datos

Referencia:
Li T, Vedula SS, Hadar N, Parkin C, Lau J, Dickersin K. Innovations in data collection, management, and archiving for systematic reviews. Ann Intern Med. 2015; 162(4):287-94.

martes, 10 de febrero de 2015

GRADE en Journal of Clinical Epidemiology

Referencias:

1. Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knotterus A. GRADE guidelines: A new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011; 64 (4): 380–82.

2. Guyatt G, Oxman AD, Akl E, Kunz R, Vist G, Brozek J, et al. GRADE guidelines 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011; 64 (4): 383–94

3. Guyatt GH, Oxman AD, Kunz R, Atkins D, Brozek J, Vist G, et al. GRADE guidelines 2. Framing the question and deciding on important outcomes. J Clin Epidemiol. 2011; 64 (4): 395-400.

4. Balshem H, Helfand M, Schunemann HJ, Oxman AD, Kunz R, Brozek J, et al. GRADE guidelines 3: rating the quality of evidence - introduction. J Clin Epidemiol. 2011; 64 (4): 401-6.

5. Guyatt GH, Oxman AD, Vist G, Kunz R, Brozek J, Alonso-Coello P, et al. GRADE guidelines 4: rating the quality of evidence - risk of bias. J Clin Epidemiol. 2011; 64 (4): 407-15.

6. Guyatt GH, Oxman AD, Montori V, Vist G, Kunz R, Brozek J, et al. GRADE guidelines 5: rating the quality of evidence - publication bias. J Clin Epidemiol. 2011; 64 (12): 1277-82.

7. Guyatt G, Oxman AD, Kunz R, Brozek J, Alonso-Coello P, Rind D, et al. GRADE guidelines 6. Rating the quality of evidence - imprecision.  J Clin Epidemiol. 2011; 64 (12): 1283-93.

8. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M; The GRADE Working Group. GRADE guidelines: 7. Rating the quality of evidence - inconsistency. J Clin Epidemiol. 2011; 64 (12): 1294-1302.

9. Guyatt GH, Oxman AD, Kunz R, Woodcock J, Brozek J, Helfand M; The GRADE Working Group. GRADE guidelines: 8. Rating the quality of evidence - indirectness. J Clin Epidemiol. 2011; 64 (12): 1303-10.

10. Guyatt GH, Oxman AD, Sultan S, Glasziou P, Akl EA, Alonso-Coello P; The GRADE Working Group. GRADE guidelines: 9. Rating up the quality of evidence. J Clin Epidemiol. 2011; 64 (12): 1311-16.

11. Brunetti M, Shemilt I, Pregno S, Vale L, Oxman AD, Lord J; The GRADE Working. GRADE guidelines: 10. Rating the quality of evidence for resource use. J Clin Epidemiology. 2013; 66(2):140-50.

12. Guyatt G, Oxman AD, Sultan S, Brozek J, Glasziou P, Alonso-Coello P, et al. GRADE guidelines: 11. Making an overall rating of confidence in effect estimates for a single outcome and for all outcomes. J Clin Epidemiol. 2013; 66(2):151-7.

13. Guyatt GH, Oxman AD, Santesso N, Helfand M, Vist G, Kunz R, et al. GRADE guidelines 12. Preparing Summary of Findings tables-binary outcomes. J Clin Epidemiol. 2013; 66(2):158-72.

14. Guyatt GH, Thorlund K, Oxman AD, Walter SD, Patrick D, Furukawa TA, et al. GRADE guidelines 13. Preparing Summary of Findings tables-continuous outcomes. J Clin Epidemiology 2013; 66(2):173-83.

15. Andrews J, Guyatt G, Oxman AD, Alderson P, Dahm P, Falck-Ytter Y, et al. GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol. 2013; 66(7):719-25.


16. Andrews JC, Schünemann HJ, Oxman AD, Pottie K, Meerpohl JJ, Coello PA, et al. GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength. J Clin Epidemiol. 2013; 66(7): 726-35. 

sábado, 7 de febrero de 2015

Haga primero el protocolo...

...aquí está una guía.

Referencia:
Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew; PRISMA-P Group. Preferredreporting items for systematic review and meta-analysis protocols (PRISMA-P)2015 statement. Syst Rev. 2015;4(1):1. 

Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A Deceased, Petticrew M; the PRISMA-P Group. Preferred reporting items for systematic review and meta-analysisprotocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647. 

No incluya dos veces los mismo datos...

...tendrá el doble o más en el efecto de la intervención. ¡Es un sesgo!

Referencia:

viernes, 6 de febrero de 2015

Desarrollando las tablas de resumen de los hallazgos con GRADE

Referencia:
http://www.guidelinedevelopment.org/ 
Acceso 6 de febrero de 2015

Para redactar el protocolo de los ensayos clínicos de intervención

Referencia:
http://www.spirit-statement.org/spirit-statement/(acceso: 6 de febrero de 2015)

¿Es un Spin trial?


1 ¿Es un ensayo cruzado, tal cómo lo presentan los autores?
Esa pregunta genera otras...

2. Si la cicatrización completa es, potencialmente, el principal criterio directo de valoración, ¿Por qué enfatizan en sangrado?

Referencia:
Córdoba-Fernandez A, Rayo-Rosado R, Juarez-Jiménez JM. Platelet gel for the surgical treatment of onychocryptosisJ Am Podiatr Med Assoc. 2008;98(4):296-301.