INFORME DE BÚSQUEDA SISTEMÁTICA DE EVIDENCIA DE LOS EFECTOS DESEABLES E INDESEABLES Guía de práctica clínica Asma Bronquial moderada y grave en menores de 15 años del régimen de garantías explícitas en salud (GES)
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INFORME DE BÚSQUEDA SISTEMÁTICA DE EVIDENCIA DE LOS EFECTOS
DESEABLES E INDESEABLES
Guía de práctica clínica Asma Bronquial moderada y grave en
menores de 15 años del régimen de garantías explícitas en
salud (GES)
1
Índice
TABLA RESUMEN ..................................................................................................................................... 2
ESTRATEGIA DE BÚSQUEDA .................................................................................................................... 3
CRITERIOS DE INCLUSIÓN ........................................................................................................................ 3
RECOLECCIÓN, ANÁLISIS Y SÍNTESIS DE DATOS ....................................................................................... 4
Selección de las revisiones .................................................................................................................. 4
Mapeo de la evidencia ........................................................................................................................ 4
ACTUALIZACIÓN – “LIVING” ..................................................................................................................... 4
Apéndice 1. Estrategias de búsqueda ................................................................................................. 5
Apéndice 2. Diagrama de flujo PRISMA .............................................................................................. 7
Apéndice 3. Referencias seleccionadas .............................................................................................. 8
2
TABLA RESUMEN
Problema de salud Asma Bronquial moderada y grave en menores de 15
años
ICD10 J45
Fecha de entrega 08/10/2017
Investigador responsable Gabriel Rada Giacaman
Número de revisiones sistemáticas 349
Número de preguntas 53
L·OVE Asthma
Dirección web L·OVE https://love.epistemonikos.org/#/diseases/asthma/a
bout
3
ESTRATEGIA DE BÚSQUEDA
Se realizaron búsquedas en Epistemonikos, una base de datos exhaustiva de revisiones sistemáticas
relevantes para la toma de decisiones en salud. La búsqueda de evidencia fue realizada en las
siguientes bases de datos1 con las estrategias descritas en el Apéndice 1.
1. Cochrane database of systematic reviews (CDSR)
2. Database of Abstracts of Reviews of Effectiveness (DARE)
3. HTA Database
4. PubMed
5. LILACS
6. CINAHL.
7. PsychlNFO.
8. EMBASE.
9. EPPI-Centre Evidence Library
10. 3ie Systematic Reviews and Policy Briefs Campbell Library
11. Clinical Evidence.
12. SUPPORT Summaries
13. WHO lnstitutional Repository for lnformation Sharing
14. NICE public health guidelines and systematic reviews
15. ACP Journal Club.
16. Evidencias en Pediatría
17. The JBI Database of Systematic Reviews and lmplementation Reports
CRITERIOS DE INCLUSIÓN
Consideramos todas las revisiones sistemáticas que están sintetizando estudios primarios (tanto
experimentales como observacionales) de acuerdo a la definición empleada por la Colaboración
Cochrane y la declaración PRISMA.2
Una revisión elegible debe cumplir con los siguientes criterios operacionales:
1. Reporta una búsqueda en al menos una base de datos electrónica.
2. Reporta al menos uno de los siguientes criterios inclusión de los estudios:
₋ Tipo de participantes: Se incluyen todas las revisiones sistemáticas que resuman
estudios que respondan la pregunta acerca de intervenciones para el alivio del dolor
por cáncer avanzado y cuidados paliativos en humanos.
₋ Tipo de desenlaces: Se incluyen revisiones que presentan una síntesis (cuantitativa o
cualitativa) de al menos un desenlace importante para el paciente u otra información
1 La actualización se realiza de manera semanal. Se encuentra disponible en la plataforma digital un sistema de alerta que
permite informar a través de correo electrónico la publicación de nuevos estudios que dan respuesta a las preguntas definidas, de manera de mantener continuamente actualizada la evidencia. 2 “Una revisión sistemática intenta recopilar toda la evidencia empírica para responder a una pregunta de investigación
específica, que cumple con criterios previamente definidos. Utiliza métodos explícitos y sistemáticos, que se eligen con miras a minimizar el sesgo, de manera de entregar hallazgos confiables que permitan sacar conclusiones y tomar decisiones”.
4
relevante para tomar decisiones poblacionales o individuales acerca de
intervenciones para el alivio del dolor por cáncer avanzado y cuidados paliativos en
humanos.
RECOLECCIÓN, ANÁLISIS Y SÍNTESIS DE DATOS
SELECCIÓN DE LAS REVISIONES Al menos dos revisores, de manera independiente, realizaron el cribado de los títulos y resúmenes
para identificar los artículos relevantes. El texto completo de las revisiones potencialmente elegibles
fue recuperado y evaluado, de manera independiente, para su inclusión final. Un tercer investigador
resolvió cualquier discrepancia que pudiera haberse provocado entre los distintos revisores.
MAPEO DE LA EVIDENCIA Con el objetivo de generar un listado exhaustivo de todas las posibles preguntas relacionadas con el
tópico del L·OVE: Asthma3, se realiza la agrupación de las revisiones resultantes en formato PICO, es
decir: población, intervención, comparación y desenlace [outcome]) utilizamos las siguientes fuentes:
1. Guías y documentos
2. Criterios de inclusión de las revisiones sistemáticas identificadas
3. Consulta con expertos
4. Retroalimentación de los usuarios
Como resultado final la plataforma incluye toda la evidencia disponible en revisiones sistemáticas y
sus estudios primarios incluidos, segregada por nodos de evidencia que representan cada una de las
preguntas priorizadas para actualización de la guía (Ver “Diagrama de flujo PRISMA” en Apéndice 2 y
“Referencia Seleccionada” en Apéndice 3).
ACTUALIZACIÓN – “LIVING” Todas las búsquedas a través de esta plataforma se mantienen continuamente actualizada gracias a
la tecnología implementada en el buscador de Epistemonikos y sus distintos colaboradores. Por lo
cual, tanto la cantidad de revisiones, preguntas, entre otros datos cambian continuamente. Los datos
presentados en este informe son los correspondientes a la fecha de entrega.
3Ver resultados de la búsqueda en: https://love.epistemonikos.org/#/diseases/asthma/about
5
APÉNDICE 1. ESTRATEGIAS DE BÚSQUEDA Cochrane Library - Cochrane database of systematic reviews (CDSR) http://www.thecochranelibrary.com (asthm* OR wheez* OR (bronch* AND hyperreactiv*)), in Title, Abstract, Keywords: Cochrane Reviews (Reviews NOT protocols) Medline/PubMed - US National Library of Medicine http://www.ncbi.nlm.nih.gov/pubmed/ (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) AND (MEDLINE[Title/Abstract] OR (systematic[Title/Abstract] AND review[Title/Abstract]) OR meta analysis[Publication Type]) EMBASE (Excerpta Medica dataBASE) http:// www.embase.com Frequency of search: weekly (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) AND meta-analysis.tw. OR systematic review.tw CINAHL (Cumulative Index to Nursing and Allied Health Literature) https://www.ebscohost.com/nursing/products/cinahl-databases/the-cinahl-database (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) AND ((TI meta analys* or AB meta analys*) or (TI systematic review or AB systematic review)) PsycINFO http://www.apa.org/pubs/databases/psycinfo (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) AND (meta-analysis OR search*) LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) http://lilacs.bvsalud.org/en/ (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) AND (tw:"revision sistematica" or tw:"revisao sistematica" or tw:"systematic review") or ((MH:"Literatura de Revision como asunto" OR MH:"Metanalisis como asunto" OR PT:Revision OR PT:Metanalisis) and (TW:Metaanal$ OR TW:"Meta-analysis" OR TW:"Meta-analise" OR TW:"Meta-analisis" OR TI:overview$ or TW:"estudio sistematico" OR TW:"systematic study" OR TW:"estudo sistematico" OR TI:review OR TI:revisao OR TI:revision)) DARE (Database of Abstracts of Reviews of Effectiveness) - Centre for Reviews and Dissemination, University of York http://www.crd.york.ac.uk/CRDWeb/ (asthm* OR wheez* OR (bronch* AND hyperreactiv*)), in Any field: CRD assessed review (bibliographic)/ CRD assessed review (full abstract) HTA Database http://www.crd.york.ac.uk/CRDWeb/ (asthm* OR wheez* OR (bronch* AND hyperreactiv*)), in Any field
The Campbell Collaboration Online Library https://www.campbellcollaboration.org/library.html (asthm* OR wheez* OR (bronch* AND hyperreactiv*)), in Title: Review
6
JBI Database of Systematic Reviews and Implementation Reports http://journals.lww.com/jbisrir/pages (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) AND (review OR meta*), in All fields EPPI-Centre Evidence Library http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=56 (asthm* OR wheez* OR (bronch* AND hyperreactiv*)) All records in chronological list (http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=62)
7
APÉNDICE 2. DIAGRAMA DE FLUJO PRISMA
8
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