Randomized trials, observational registries, and the foundations of evidence-based medicine.
Am J Cardiol
; 113(8): 1436-41, 2014 Apr 15.
Article
en En
| MEDLINE
| ID: mdl-24576540
Although randomized trials and observational studies are used as the evidentiary basis of clinical practice guidelines, they are not always in agreement. Limitations in the process of randomization in the former and the selective referral of patients for treatment as a consequence of clinical "risk stratification" in the latter are underappreciated causes for these disagreements. As a result, neither is guaranteed to correctly quantify treatment benefit. This essay reviews the operational differences between these alternative evidentiary sources and shows how these differences can affect individual clinical decisions, population-based practice guidelines, and national health policy. In conclusion, the process of evidence-based medicine can be improved by independent agencies charged with the responsibility to identify and resolve these differences.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedades Cardiovasculares
/
Ensayos Clínicos Controlados Aleatorios como Asunto
/
Sistema de Registros
/
Medicina Basada en la Evidencia
Tipo de estudio:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
Am J Cardiol
Año:
2014
Tipo del documento:
Article
Pais de publicación:
Estados Unidos