Medicina baseada na evidência e meta-análise: à procura do Santo Graal

Autores

  • Rui Moreno Hospital de Santo António dos Capuchos, Lisboa
  • João Paulo Caixinha Hospital de Santo António dos Capuchos, Lisboa
  • Ricardo Matos Hospital de Santo António dos Capuchos, Lisboa
  • Teresa Fevereiro Hospital de Santo António dos Capuchos, Lisboa

Palavras-chave:

Medicina baseada na evidên­cia, meta-análise, ensaios clínicos controlados aleatórios, formação médica

Resumo

Os autores reflectem sobre a evolução da for­mação médica, achando excessiva a ênfase dada actualmente à Medicina baseada na evidência e à meta-andlise. Baseados numa análise dos pro­blemas metodológicos dos ensaios clínicos con­trolados aleatórios e da meta-análise, tecem al­gumas considerações sobre a utilização destes métodos na prática clínica.

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Referências

Haynes RB, McKibbon A, Alker CJ, Ryan N, Fitzgerald D, Rams­ den ME. Online access to MEDLINE in clinical settings: a large, simple trials and overviews of trials. J Clin Epidemiol 1995; 48: 23-40.

Hodgkin P. Medicine, postmodernism, and the end of certainty. Br Med J 1996; 313: 1568-1569.

Cook DJ, Sihhald WI. Vincent J-L, Cerra FB, Group ftEBMiCC. Evidence based critical care medicine: what is it and what

can it do for us' Crit Care Med 1996; 24: 334-337.

Beal AL, Cerra FB. Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction.

JAMA 1994: 271: 226-233.

Davidoff F, Haynes B, Sackett D, Smith R. Evidence-based me­dicine. Br Med J 1995; 310: 1085-1086.

Sackett DL, Rosenberg WM, Grat JA, Haynes RB, Richardson WS. Evidence based medicine: what it is and what it isn't. Br Med J; 312: 71-72.

Hellman S, Hellman DS. Of mice but not men. Problems of the randomized clinical trial. N Eng!J Med 1991; 324: 1585-1589.

Schulz KF. Subverting randomization in controlled triais. JAMA 1995; 274: 1456-1458.

Veloso A. ''Evidence-based medicine": a arte e o ofício. Tempo Medicina 2 Fev. 1998.

Naylor CD. Grey zones of clinicai practice: some limits to evi­denced-hased medicine. Lancet 1995; 345: 840-842.

Bailar III JC. The practice of meta-analysis. J Clin Epidemiol 1995; 48: 149-157.

Olkin J. Meta-analysis: reconciling the results of independent studies. Stat Med 1995; 14: 457-472.

Sacks HS, Berrier J, Reitman D, Ancona-Berk VA, Chalmers TC. Meta-analyses of randomized controlled trials. N Engl J Med 1987; 316: 450-455.

Slavin RE. Best evidence synthesis: an intelligent alternative to meta-analysis. J Clin Epidemiol 1995; 48: 9-18.

Peto R, Collins R, Gray R. Large-scale randomized evidence: study of use and usefulness. Ann lntern Med 1990; 112: 78- 84.

Glass GV. Primary, secundary and meta-analysis of research. Educ Res 1976; 5: 3-8.

Goldman L, Feinstein AR. Anticoagulant and myocardial in­farction. The problems of pooling, drowning and floating. Ann lntern Med 1979; 90: 92-94.

Feinstein AR. Meta-analysis: statistical alchemy for the 21st cen­tury. J Clin Epidemiol 1995; 48: 71-79.

Meinert CL Meta-analysis: science or religion? Control Clin Trials 1989; 10(Supp. 4): 2575-2635.

Spitzer WO. Meta-meta-analysis: unsanwered questions about aggregating data. J Clin Epidemiol 1991; 44: 103-107.

Chalmers TC, Matta RJ, Smith Jr. HJ, et al. Evidence favoring the use of anticoagulants in the hospital phase of acute myocardial infarction. N Engl J Med 1977; 297: 1091-1096.

Cook DJ, Sacket DL, Spitzer WO. Methodologic guidelines for systematic reviews of randomized control trials in health care from the Potsdam consultation on meta-analysis. J Clin Epidemiol 1995; 48: 167-171.

Lau J, lonnidis JP, Schmid CH. Summing up evidence: one answer is not always enough. Lancet 1998; 351: 123-127.

Grégoire G, Derderian F, Le Lorier J. Selecting the language of the publications included in a meta-analysis: is there a to­wer of babel bias? J Clin Epidemiol 1995; 48: 159-163.

LeLorier J, Gregoire G, Benhaddad A, Lapierre J, et al. Discre­pancies between meta-analysis and subsequent large ran­domized, controlled trials. N Engl J Med 1997; :B7: 536-542.

Feinstein AR, Horwitz RI. Problems in the "evidence"of "evi­dence-based medicine". Am J Med 1997; 103: 529-535.

Fowler PB. Evidence-hased everything.. J Eval Clin Pract 1997; 3: 239-243.

Knottnems JA, Dinant GJ. Medicine based evidence, a prere­quisite for evidenced based medicine. Br Med J 1997; 315: 1109-1110.

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Publicado

30-06-1998

Como Citar

1.
Moreno R, Caixinha JP, Matos R, Fevereiro T. Medicina baseada na evidência e meta-análise: à procura do Santo Graal. RPMI [Internet]. 30 de Junho de 1998 [citado 16 de Novembro de 2024];5(2):139-41. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/2136

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