Lectura Critica de articulos médicos
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El documento habla sobre la importancia de realizar una lectura crítica de artículos científicos para tomar decisiones clínicas basadas en la evidencia. Explica que la lectura crítica implica evaluar la validez de los resultados a través de comprobar aspectos técnicos como la aleatorización y asignación de tratamientos, y determinar la magnitud y aplicabilidad de los resultados a los pacientes.
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Lectura Critica de articulos médicos
- 1. Rafael Bravo Toledo área 10 de atención primaria IMSALUD. Getafe, Madrid Lectura crítica de artículos científicos Centro de Salud Sector III
- 2. envenenamiento Power Point: un nuevo síndrome resumen diapositivas en internet:
- 3. uso consciente, explícito y juicioso de la mejor evidencia disponible para tomar decisiones clínicas en el cuidado de los pacientes .
- 7. sin embargo no leemos todo lo que debiéramos Número de revistas no leídas poca moderada muchísima Culpabilidad
- 9. Hay que leer pero no queremos volvernos locos, ni sentirnos culpables hacerlo de una manera especial
- 11. Valoración crítica de la literatura científica ¿Pueden aplicarse los resultados a la asistencia de mis pacientes? ¿Podemos confiar en los resultados? ¿qué resultados?
- 14. diferenciar POEMS de DOES
- 15. Para qué no nos engañen con los números 1%
- 16. Efecto del tratamiento con donepezilo (14 semanas) en enfermedad de Alzheimer leve y moderada Para qué no nos engañen con las gráficas
- 17. como apareció, en el artículo Start End Bandolier, June 1997, No. 40 donepezil placebo better
- 18. Efecto del tratamiento con donepezilo (14 semanas) en enfermedad de Alzheimer leve y moderada better donepezil placebo Start End Bandolier, June 1997, No. 40
- 19. Para saber lo que es NNT
- 24. Guyatt GH, Rennie D. Users' guides to the medical literature JAMA 1993;270:2096-7 .
- 26. -Son validos los resultados del estudio Si / No / No sabe Se determina la validez del estudio 1- La asignación de los pacientes al tratamiento ¿se hizo de manera aleatoria? 2- La aleatorización ¿se realizó de forma enmascarada? es decir se oculto la asignación a los grupos 3--¿Eran similares los grupos al inicio del ensayo 4-¿Fueron los pacientes, médicos y personal evaluador de los resultados estudio "ciegos" con respecto al tratamiento administrado? 5 -¿Se realiza un seguimiento completo y exhaustivo de todos los pacientes hasta el final del estudio? 6-Aparte de la intervención experimental, ¿se trato a los grupos de la misma forma? ¿Reciben la misma atención sanitaria ambos grupos? 7 ¿Fueron analizados en los grupos a los que se les asigno en la distribución aleatoria? Análisis por intención de tratar.
- 27. Cálculos : -Cuales fueron los resultados Se determina si los resultados son importantes ¿Cuál es la magnitud del efecto? Eventos favorables Reducción relativa del riesgo. RRR Reducción absoluta del riesgo. RAR Número necesario a tratar. NNT Variables de valoración TEE TEC TEC - TEE TEC TEC - TEE 1/TEC-TEE Variable primaria de valoració n Otras variables
- 28. ¿Son los resultados aplicables a mis pacientes ? Si / No / No sabe ¿Se pueden aplicar los resultados a la asistencia de mi paciente? ¿Son mis pacientes muy diferentes a los que participaron en el estudio? ¿Puedo utilizar el mismo tratamiento en mi medio? ¿Son los resultados aplicables a mis pacientes ? Si / No / No sabe ¿Los beneficios potenciales superan a los inconvenientes de este tratamiento? ¿Considero los valores y expectativas de mi paciente con respecto al tratamiento y sus resultados?
- 29. A systematic review of the content of critical appraisal tools http://www.biomedcentral.com/1471-2288/4/22
- 40. Valoración crítica de la literatura científica ¿Pueden aplicarse los resultados a la asistencia de mis pacientes? ¿Podemos confiar en los resultados? ¿qué resultados?
- 41. validez: claves técnicas magnitud de los resultados aplicabilidad a la práctica
Notas del editor
- http://www.slideshare.net/rafabravo/pbe-2008559
- Journal associated score of personal angst 0 (?liar) 1-3 (normal range) >3 (sick; at risk for polythenia gravis and related conditions) BMJ 1995;311:1666-1668
- How to read clinical journals: CMAJ 1981-1984 Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: I. Why to read them and how to start reading them critically. Can Med Assoc J 1981;124:555-8. Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: II. To learn about a diagnostic test. Can Med Assoc J 1981;124:703-10. - Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: III. To learn the clinical course and prognosis of disease. Can Med Assoc J 1981;124:869-72. - Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: IV. To determine etiology or causation. Can Med Assoc J 1981;124:985-90. - Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: V. To distinguish useful from useless or even harmful therapy. Can Med Assoc J 1981;124:1156-62. Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: VI. To learn about the quality of clinical care. Can Med Assoc J 1984;130:377-81. - Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: VII: To understand an economic evaluation (Part A). Can Med Assoc J 1984;130:1428-34. Department of Clinical Epidemiology and Biostatistics, McMaster University. Health Sciences Centre. How to read clinical journals: VII: To understand an economic evaluation (Part B). Can Med Assoc J 1984;130:1542-9 How to keep up with the medical literature (Annals of Internal Medicine, 1986) I) Why try to keep up and how to get started. (1986;105:149-53). II) Deciding which journals to read regularly. (1986;105:309-12). III) Expanding the number of journals you read regularly. (1986;105:474-8). IV) Using the literature to solve clinical problems. (1986;105:636-40). V) Access by personal computer to the medical literature. (1986;105:810-24. VI) How to store and retrieve articles worth keeping. (1986;105:978-84).
- Guyatt GH, Rennie D. Users' guides to the medical literature. [editorial]. (1993;270:2096-7). I) How to get started. (1993;270:2093-5). II) How to use an article about therapy or prevention. A. Are the results of the study valid? (1993;270:2598-601). B. What were the results and will they help me in caring for my patients? (1994;271:59-63). III) How to use an article about a diagnostic test. A. Are the results of the study valid? (1994;271:389-91). B. What are the results and will they help me in caring for my patients? (1994;271:703-7). IV) How to use an article about harm. (1994;271:1615-9). V) How to use an article about prognosis. (1994;272:234-7). VI) How to use an overview. (1994;272:1367-71). VII) How to use a clinical decision analysis. A. Are the results of the study valid? (1995;273:1292-5). B. What are the results and will they help me in caring for my patients? (1995;273:1610-3). VIII) How to use clinical practice guidelines. A. Are the recommendations valid? (1995;274:570-4). B. What are the recommendations and will they help you in caring for your patients? (1995;274:1630-2). IX) A method for grading health care recommendations. (1995;274:1800-4). (Correzioni in JAMA 1996;275:1232). X) How to use an article reporting variations in the outcomes of health services. (1996;275:554-8). XI) How to use an article about a clinical utilization review. (1996;275:1435-9). XII) How to use articles about health-related quality of life. (1997;277:1232-7). XIII) How to use an article on economic analysis of clinical practice. A. Are the results of the study valid? (1997;277:1552-7). B. What are the results and will they help me in caring for my patients? (1997;277:1802-6). (Correzioni in JAMA 1997;278:1064). XIV) How to decide on the applicability of clinical trial results to your patient. (1998;279:545-9). XV) How to use an article about disease probability for differential diagnosis. (1999;281:1214-9). XVI) How to use a treatment recommendation. (1999;281:1836-43, a cura anche del Cochrane Applicability Methods Working Group). XVII) How to use guidelines and recommendations about screening. (1999;281:2029-34). XVIII) How to use an article evaluating the clinical impact of a computer-based clinical decision support system. (1999;282:67-74). XIX) Applying clinical trial results. A. How to use an article measuring the effect of an intervention on surrogate end points. (1999;282:771-8) . B. Guidelines for determining whether a drug is exerting (more than) a class effect. (1999;282:1371-7). XX) Integrating research evidence with the care of the individual patient. (2000;283:2829-36). XXI) Using electronic health information resources in evidence-based practice. (2000;283:1875-9). XXII) How to use articles about clinical decision rules. (2000;284:79-84). XXIII) Qualitative research in health care. A. Are the results of the study valid? (2000;284:357-62). B. What are the results and how do they help me care for my patients? (2000;284:478-82). XXIV) How to use an article on the clinical manifestations of disease . (2000;284:869-75). XXV) Evidence-based medicine: principles for applying the Users' Guides to patient care . (2000;284:1290-6). HOW TO READ A PAPER (Bmj julio-septiembre 1997) 1) The Medline database . (1997;315:180-3).2) Getting your bearings (deciding what the paper is about). (1997;315:243-6).3) Assessing the methodological quality of published papers. (1997;315:305-8).4) Statistics for the non-statistician. I: Different types of data need different statistical tests. (1997;315:364-6).5) Statistics for the non-statistician. II: “Significant” relations and their pitfalls. (1997;315:422-5).6) Papers that report drug trials. (1997;315:480-3).7) Papers that report diagnostic or screening tests. (1997;315:540-3).8) Papers that tell you what things cost (economic analyses). (1997;315:596-).9) Papers that summarise other papers (systematic reviews and meta-analyses). (1997;315:672-5).10) Papers that go beyond numbers (qualitative research). (1997;315:740-3 )
- A systematic review of the content of critical appraisal tools http://www.biomedcentral.com/1471-2288/4/22 ackground Consumers of research (researchers, administrators, educators and clinicians) frequently use standard critical appraisal tools to evaluate the quality of published research reports. However, there is no consensus regarding the most appropriate critical appraisal tool for allied health research. We summarized the content, intent, construction and psychometric properties of published, currently available critical appraisal tools to identify common elements and their relevance to allied health research. Methods A systematic review was undertaken of 121 published critical appraisal tools sourced from 108 papers located on electronic databases and the Internet. The tools were classified according to the study design for which they were intended. Their items were then classified into one of 12 criteria based on their intent. Commonly occurring items were identified. The empirical basis for construction of the tool, the method by which overall quality of the study was established, the psychometric properties of the critical appraisal tools and whether guidelines were provided for their use were also recorded. Results Eighty-seven percent of critical appraisal tools were specific to a research design, with most tools having been developed for experimental studies. There was considerable variability in items contained in the critical appraisal tools. Twelve percent of available tools were developed using specified empirical research. Forty-nine percent of the critical appraisal tools summarized the quality appraisal into a numeric summary score. Few critical appraisal tools had documented evidence of validity of their items, or reliability of use. Guidelines regarding administration of the tools were provided in 43% of cases. Conclusions There was considerable variability in intent, components, construction and psychometric properties of published critical appraisal tools for research reports. There is no "gold standard' critical appraisal tool for any study design, nor is there any widely accepted generic tool that can be applied equally well across study types. No tool was specific to allied health research requirements. Thus interpretation of critical appraisal of research reports currently needs to be considered in light of the properties and intent of the critical appraisal tool chosen for the task.
- http://www.bmj.com/cgi/search?fulltext=how+to+read+a+paper&x=17&y=12