Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca
ABSTRACT: The network meta-analysis (NMA) can incorporate and analyze indirect comparisons between interventions as an aid to the development of recommendations in clinical practice guidelines. The aim of this article is to summarize the literature review conducted by the group on NMA, GRADE recomme...
- Autores:
-
Sénior Sánchez, Juan Manuel
Toro Escobar, Juan Manuel
Saldarriaga Giraldo, Clara Inés
- Tipo de recurso:
- Review article
- Fecha de publicación:
- 2016
- Institución:
- Universidad de Antioquia
- Repositorio:
- Repositorio UdeA
- Idioma:
- spa
- OAI Identifier:
- oai:bibliotecadigital.udea.edu.co:10495/12674
- Acceso en línea:
- http://hdl.handle.net/10495/12674
- Palabra clave:
- Insuficiencia Cardíaca
Metaanálisis
- Rights
- openAccess
- License
- Atribución-NoComercial-CompartirIgual 2.5 Colombia (CC BY-NC-SA 2.5 CO)
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Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| dc.title.alternative.spa.fl_str_mv |
Application of Grade to meta-analysis recommendations in the Colombian guideline for heart failure |
| title |
Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| spellingShingle |
Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca Insuficiencia Cardíaca Metaanálisis |
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Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| title_full |
Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| title_fullStr |
Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| title_full_unstemmed |
Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| title_sort |
Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca |
| dc.creator.fl_str_mv |
Sénior Sánchez, Juan Manuel Toro Escobar, Juan Manuel Saldarriaga Giraldo, Clara Inés |
| dc.contributor.author.none.fl_str_mv |
Sénior Sánchez, Juan Manuel Toro Escobar, Juan Manuel Saldarriaga Giraldo, Clara Inés |
| dc.subject.none.fl_str_mv |
Insuficiencia Cardíaca Metaanálisis |
| topic |
Insuficiencia Cardíaca Metaanálisis |
| description |
ABSTRACT: The network meta-analysis (NMA) can incorporate and analyze indirect comparisons between interventions as an aid to the development of recommendations in clinical practice guidelines. The aim of this article is to summarize the literature review conducted by the group on NMA, GRADE recommendations and to evaluate how the recommendation for this question of the guideline was developed. Methodology: To the question about the use of beta-blockers (BB) in patients with heart failure stage C ACC/AHA, a systematic search was conducted. An NMA was found that summarized the findings of other studies; it was suitable to describe the application of GRADE criteria as an example in this type of studies. Results: The overall result of the meta-analysis showed a significant reduction in mortality with the use of BB against any comparator. All comparisons were indirect except the study of carvedilol with metoprolol tartrate. All BB showed reduced mortality, but no statistical significance when compared with each other. This NMA did not publish probability in the order of treatment. Analysis of the general characteristics of the studies included in the NMA did not showed intransitivity. For comparison between metoprolol and carvedilol it was seen that the effect of direct and indirect comparison was consistent. Conclusion: NMA are a way of summarizing the available evidence including indirect comparisons, they have a particular methodology and the criteria of the GRADE group are practical and applicable as was shown in the development of this clinical practice guideline. |
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2016 |
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2016 |
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2019-12-20T17:48:41Z |
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2019-12-20T17:48:41Z |
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Sénior Sánchez JM, Toro Escobar JM, Saldarriaga Giraldo CI. Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca. Iatreia. 2016 Oct; 29(S4): S93-S105. |
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0121-0793 |
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http://hdl.handle.net/10495/12674 |
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2011-7965 |
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Sénior Sánchez JM, Toro Escobar JM, Saldarriaga Giraldo CI. Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca. Iatreia. 2016 Oct; 29(S4): S93-S105. 0121-0793 2011-7965 |
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Universidad de Antioquia, Facultad de Medicina |
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Medellín, Colombia |
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Universidad de Antioquia |
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Sénior Sánchez, Juan ManuelToro Escobar, Juan ManuelSaldarriaga Giraldo, Clara Inés2019-12-20T17:48:41Z2019-12-20T17:48:41Z2016Sénior Sánchez JM, Toro Escobar JM, Saldarriaga Giraldo CI. Aplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíaca. Iatreia. 2016 Oct; 29(S4): S93-S105.0121-0793http://hdl.handle.net/10495/126742011-7965ABSTRACT: The network meta-analysis (NMA) can incorporate and analyze indirect comparisons between interventions as an aid to the development of recommendations in clinical practice guidelines. The aim of this article is to summarize the literature review conducted by the group on NMA, GRADE recommendations and to evaluate how the recommendation for this question of the guideline was developed. Methodology: To the question about the use of beta-blockers (BB) in patients with heart failure stage C ACC/AHA, a systematic search was conducted. An NMA was found that summarized the findings of other studies; it was suitable to describe the application of GRADE criteria as an example in this type of studies. Results: The overall result of the meta-analysis showed a significant reduction in mortality with the use of BB against any comparator. All comparisons were indirect except the study of carvedilol with metoprolol tartrate. All BB showed reduced mortality, but no statistical significance when compared with each other. This NMA did not publish probability in the order of treatment. Analysis of the general characteristics of the studies included in the NMA did not showed intransitivity. For comparison between metoprolol and carvedilol it was seen that the effect of direct and indirect comparison was consistent. Conclusion: NMA are a way of summarizing the available evidence including indirect comparisons, they have a particular methodology and the criteria of the GRADE group are practical and applicable as was shown in the development of this clinical practice guideline.RESUMEN: Los metaanálisis en red (MAR) permiten incorporar y analizar comparaciones indirectas entre intervenciones y son una ayuda para la elaboración de recomendaciones en las guías de práctica clínica. El objetivo de este artículo es resumir la revisión bibliográfica que realizó el grupo sobre MAR, las recomendaciones del grupo GRADE para evaluarlos y la forma como se elaboró la recomendación para esta pregunta de la la guía. Metodología: para la pregunta sobre el uso de betabloqueadores (BB) en pacientes con síndrome de falla cardíaca clasificación C de la ACC/AHA se hizo una búsqueda sistemática. Se encontró un MAR, que resumía los hallazgos para responderla, con el cual se describe la aplicación de GRADE en este tipo de estudios. Resultados: el resultado global del metaanálisis mostró una reducción significativa de la mortalidad con el uso de BB contra cualquier comparador; todas son comparaciones indirectas excepto el estudio de carvedilol contra metoprolol tartrato. Todos los BB mostraron reducción de la mortalidad, pero no hubo significancia estadística cuando se compararon entre ellos. Este MAR no publicó la probabilidad en el orden de tratamiento y el análisis de las características generales de los estudios incluidos en él no mostró intransitividad; además, la comparación entre metoprolol y carvedilol demostró coherencia de la comparación directa y la indirecta. Conclusión: Los MAR son una forma de resumir la evidencia disponible incluyendo comparaciones indirectas, tienen una metodología particular y los criterios del grupo GRADE son prácticos y aplicables como mostramos se hizo en el desarrollo de esta guía de práctica clínica.12application/pdfspaUniversidad de Antioquia, Facultad de MedicinaMedellín, Colombiainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_dcae04bchttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARTREVArtículo de revisiónhttp://purl.org/coar/version/c_970fb48d4fbd8a85Atribución-NoComercial-CompartirIgual 2.5 Colombia (CC BY-NC-SA 2.5 CO)info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/co/http://purl.org/coar/access_right/c_abf2https://creativecommons.org/licenses/by-nc-sa/4.0/Insuficiencia CardíacaMetaanálisisAplicación del Grade en las recomendaciones de meta-análisis en red en la guía Colombiana de falla cardíacaApplication of Grade to meta-analysis recommendations in the Colombian guideline for heart failureIatreiaIatreia93105294ORIGINALSeniorJuan_2016_AplicaciónGradeFallaCardiaca.pdfSeniorJuan_2016_AplicaciónGradeFallaCardiaca.pdfArtículo de revisiónapplication/pdf1004519http://bibliotecadigital.udea.edu.co/bitstream/10495/12674/1/SeniorJuan_2016_Aplicaci%c3%b3nGradeFallaCardiaca.pdf16f8d243f884590831a612a6f32dd23aMD51CC-LICENSElicense_urllicense_urltext/plain; charset=utf-849http://bibliotecadigital.udea.edu.co/bitstream/10495/12674/2/license_url4afdbb8c545fd630ea7db775da747b2fMD52license_textlicense_texttext/html; charset=utf-80http://bibliotecadigital.udea.edu.co/bitstream/10495/12674/3/license_textd41d8cd98f00b204e9800998ecf8427eMD53license_rdflicense_rdfapplication/rdf+xml; charset=utf-80http://bibliotecadigital.udea.edu.co/bitstream/10495/12674/4/license_rdfd41d8cd98f00b204e9800998ecf8427eMD54LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://bibliotecadigital.udea.edu.co/bitstream/10495/12674/5/license.txt8a4605be74aa9ea9d79846c1fba20a33MD5510495/12674oai:bibliotecadigital.udea.edu.co:10495/126742021-04-03 18:25:25.181Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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 |