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Para médicos oncólogos

¿Cómo practicar evidencia oncológica?

Presentaciones del seminario de la Escuela Europea de Oncología.

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Education and debate - Assessing the quality of research
por Paul Glasziou, Jan Vandenbroucke and Iain Chalmers | 2004
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Autor: Paul Glasziou, Jan Vandenbroucke and Iain Chalmers
Tipo de documento:
Idioma:
Año: 2004
Link: www.bmj.com
Actualizado: 2004-07-17
Inflexible use of evidence hierarchies confuses practitioners and irritates researchers. So how can we improve the way we assess research?

  
Why do doctors use treatments that do not work?
por Jenny Doust and Chris Del Mar | 2004
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Autor: Jenny Doust and Chris Del Mar
Tipo de documento:
Idioma:
Año: 2004
Link: www.bmj.com
Actualizado: 2004-07-17
Reasons for using ineffective or harmful treatments
- Clinical experience
- Over-reliance on a surrogate outcome
- Natural history of the illness
- Love of the pathophysiological model (that is wrong)
- Ritual and mystique
- A need to do something
- No one asks the question
- Patients’ expectations (real or assumed)
  
Evidence-based oncology in cancer treatment reviews
por Benjamin Djulbegovic, Robert Coleman, Rolf Stahel, Debbie Singh and Gary Lyman | 2003
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Autor: Benjamin Djulbegovic, Robert Coleman, Rolf Stahel, Debbie Singh and Gary Lyman
Tipo de documento:
Idioma:
Año: 2003
Link: http://www.cancertreatmentreviews.com/
Actualizado: 2003-07-17
Between 1966 and November 2002 there were
1,395,900 oncology articles listed in MEDLINE, the
US National Library of Medicine database. Of these
about 800,000 were related to treatment, about
500,000 focused on diagnosis and around 100,000
were about prognosis in patients with malignant
disorders. A significant number of these articles are
not relevant to clinical practice or are of dubious
quality. But how do we know which to read and
integrate into our clinical practice? Our new Evidence
Based Oncology section aims to help clinicians identify,
evaluate and apply the ‘best evidence’ to their
clinical practice. This paper outlines the philosophy
behind our new Evidence-based Oncology section (1).
  
Survival Analysis Part I: Basic concepts and first analyses
por TG Clark,Bradburn,Love,Altman | 2003
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Autor: TG Clark,Bradburn,Love,Altman
Tipo de documento:
Idioma:
Año: 2003
Link: www.bjcancer.com
Actualizado: 2003-07-17
Tutorial Paper
  
The Landscape and Lexicon of Blinding in Randomized Trials
por Schulz,Chalmers,Altman | 2002
Detalle
Autor: Schulz,Chalmers,Altman
Tipo de documento:
Idioma:
Año: 2002
Link: www.annals.org
Actualizado: 2002-07-17
 
The CONSORT Statement: Revised Recommendations for Improving the Quality of Reports of Parallel-Group Randomized Trials
por Moher,Schulz,Altman | 2001
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Autor: Moher,Schulz,Altman
Tipo de documento:
Idioma:
Año: 2001
Link: www.annals.org
Actualizado: 2001-07-17
To comprehend the results of a randomized, controlled trial (RCT),
readers must understand its design, conduct, analysis, and interpretation.
That goal can be achieved only through complete transparency
from authors. Despite several decades of educational efforts,
the reporting of RCTs needs improvement. Investigators and
editors developed the original CONSORT (Consolidated S tandards
of Reporting Trials) statement to help authors improve reporting
by using a checklist and flow diagram. The revised CONSORT
statement presented in this paper incorporates new evidence and
addresses some criticisms of the original statement.
The checklist items pertain to the content of the Title, Abstract,
Introduction, Methods, Results, and Discussion. The revised
checklist includes 22 items selected because empirical evidence
indicates that not reporting the information is associated with
biased estimates of treatment effect or because the information is
essential to judge the reliability or relevance of the findings. We
intended the flow diagram to depict the passage of participants
through an RCT. The revised flow diagram depicts information
from four stages of a trial (enrollment, intervention allocation,
follow-up, and analysis). The diagram explicitly includes the number
of participants, for each intervention group, that are included
in the primary data analysis. Inclusion of these numbers allows
the reader to judge whether the authors have performed an
intention-to-treat analysis.
In sum, the CONSORT statement is intended to improve the
reporting of an RCT, enabling readers to understand a trial’s
conduct and to assess the validity of its results.
  
Linking evidence-based medicine therapeutic summary measures to clinical decision analysis
por B.Djulbegovic,Hozo,Lyman | 2000
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Autor: B.Djulbegovic,Hozo,Lyman
Año: 2000
Link: http://www.math.iun.indiana.edu
Actualizado: 2000-07-17
Objective: Evidence-based medicine (EBM) seeks to improve clinical practice by evaluating the quality of clinical evidence and ensuring that only the “best” evidence
from clinical research is used in the management of individual patients. EBM has contributed to our understanding of the meaning of the benefit and harm of treatment as
reported in the literature and it is often promoted as an aid to clinical decision making.
However, EBM therapeutic summary measures reflect only a single dimension of clinical decision making. The purpose of this work is to show how EBM therapeutic summary measures can be effectively incorporated into medical decision making.
  
Report of an international working group to standardize response criteria for myelodysplastic syndromes
por Cheson,Bennett,Kantarjian,Pinto,Schiffer,Nimer,Lowenberg,
Beran,M. de Witte,Stone,Mittelman,Sanz,Wijermans,
Gore, and Greenberg | 2000
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Detalle
Autor: Cheson,Bennett,Kantarjian,Pinto,Schiffer,Nimer,Lowenberg, Beran,M. de Witte,Stone,Mittelman,Sanz,Wijermans, Gore, and Greenberg
Tipo de documento:
Idioma:
Año: 2000
Link: www.hematology.org/
Actualizado: 2000-07-17
Standardized criteria for assessing response are essential to ensure comparability among clinical trials for patients with myelodysplastic syndromes (MDS).
An international working group of experienced clinicians involved in the management of patients with MDS reviewed currently used response definitions and developed a uniform set of guidelines for future clinical trials in MDS. The MDS differ from many other hematologic malignancies in their chronicity and the morbidity and mortality caused by chronic cytopenias, often without disease progression to acute myeloid leukemia. Whereas response rates may be an important endpoint for phase 2 studies of new agents and may assist regulatory agencies in their evaluation and approval processes, an important goal of clinical trials in MDS should be to prolong patient survival.
Therefore, these response criteria reflected 2 sets of goals in MDS: altering the natural history of the disease and alleviating disease-related complications with improved quality of life. It is anticipated that the recommendations presented will require modification as more is learned about the molecular biology and genetics of these disorders. Until then, it is hoped these guidelines will serve to improve communication among investigators and to ensure comparability among clinical trials. (Blood. 2000;96:3671-3674)
  
Measuring of quality of trials
por Berlin, Rennie | 1999
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Autor: Berlin, Rennie
Tipo de documento:
Idioma:
Año: 1999
Actualizado: 1999-07-17
The Quality of Quality Scales
  
The Hazards of scoring the quality of clinical trials for Meta-Analysis
por Juni,Witschi,Bloch,Egger | 1999
Detalle
Autor: Juni,Witschi,Bloch,Egger
Tipo de documento:
Idioma:
Año: 1999
Link: http://www.ama-assn.org
Actualizado: 1999-07-17
 
National Cancer Institute-Sponsored Working Group Guidelines for Chronic Lymphocytic Leukemia: Revised Guidelines for Diagnosis and Treatment
por Bruce D. Cheson, John M. Bennett, Michael Grever, Neil Kay, Michael J. Keating, Susan O`Brien, and Kanti R. Rai | 1996
Detalle
Autor: Bruce D. Cheson, John M. Bennett, Michael Grever, Neil Kay, Michael J. Keating, Susan O`Brien, and Kanti R. Rai
Tipo de documento:
Idioma:
Año: 1996
Actualizado: 1996-07-17