Información de la revista
Vol. 100. Núm. 2.
Páginas 89-99 (marzo 2009)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 100. Núm. 2.
Páginas 89-99 (marzo 2009)
Review article
Acceso a texto completo
Evidence-Based Dermatology: A Synopsis
Dermatología Basada en Evidencia: una Sinopsis
Visitas
7775
J. Manríquez
Autor para correspondencia
jmanriquez@dermatoscopio.cl

Correspondence: Departamento de Dermatología, Escuela de Medicina. Pontificia Universidad Católica de Chil, Vicuña Mackenna #4686, Comuna San Joaquín, Santiago, Chile.
Departamento de Dermatología, Escuela de Medicina, Pontificia Universidad Católica de Chile
Este artículo ha recibido
Información del artículo
Abstract

The aim of evidence-based medicine is to support clinical decision making by providing tools for systematically locating, appraising, and applying the best information currently available to improve patient outcomes. This article summarizes the basic steps for practicing evidence-based medicine in the management of cutaneous diseases. Special emphasis is placed on the following 4 major steps in the process: asking a clinical question taking into consideration 4 elements; finding the evidence; critically appraising the evidence; and integrating the new information into clinical expertise and judgment, in order to make the best decision in each clinical setting.

Key words:
dermatology
evidence-based medicine
randomized controlled trials
meta-analysis
information management
systematic review
Resumen

El objetivo de la medicina basada en la evidencia es entregar herramientas que permiten localizar, evaluar y aplicar la mejor evidencia científica, permitiendo de esta forma apoyar la toma de decisiones clínicas y mejorar el cuidado de nuestros pacientes. Este artículo resume los pasos básicos para la práctica de la medicina basada en evidencia en dermatología, con énfasis en las cuatro etapas fundamentales de este proceso: la formulación de una correcta pregunta clínica, la búsqueda de la información, la evaluación crítica de la información encontrada y la integración de esta información en la experiencia y juicio clínico, con el fin de ayudar a tomar la mejor decisión según cada escenario.

Palabras clave:
dermatología
medicina basada en la evidencia
ensayo controlado aleatorizado
metaanálisis
gestión de la información
revisión sistemática
El Texto completo está disponible en PDF
References
[1.]
M. Bigby.
Paradigm lost.
Arch Dermatol, 136 (2000), pp. 26-27
[2.]
M. Bigby.
Snake oil for the 21st century.
Arch Dermatol, 134 (1998), pp. 1512-1514
[3.]
G. Webster.
Is dermatology slipping into its anecdotage?.
Arch Dermatol, 131 (1995), pp. 149-150
[4.]
H. Williams.
Dowling Oration 2001. Evidence-based dermatology—a bridge too far?.
Clin Exp Dermatol, 26 (2001), pp. 714-724
[5.]
S. Kus, D. Gun, Z. Demircay, H. Sur.
Vitamin E does not reduce the side-effects of isotretinoin in the treatment of acne vulgaris.
Int J Dermatol, 44 (2005), pp. 248-251
[6.]
J. Strauss, A. Gottlieb, T. Jones, J. Koo, J. Leyden, A. Lucky, et al.
Concomitant administration of vitamin E does not change the side effects of isotretinoin as used in acne vulgaris: a randomized trial.
J Am Acad Dermatol, 43 (2000), pp. 777-784
[7.]
E. Miller, R. Pastor-Burriuso, D. Dalal, R. Riemersma, L. Appel, E. Guallar.
Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality.
Ann Intern Med, 4 (2005), pp. 37-46
[8.]
F. Davidoff, R. Haynes, D. Sackett, R. Smith.
Evidence based medicine: a new journal to help doctors identify the information they need.
BMJ, 310 (1995), pp. 1085-1086
[9.]
K. Adetugbo, H. Williams.
How well are randomized controlled trials reported in the dermatology literature?.
Arch Dermatol, 136 (2000), pp. 381-385
[10.]
J.J. Manríquez, G. Valdivia, G. Rada, L.M. Letelier.
Análisis crítico de ensayos clínicos randomizados publicados en revistas biomédicas chilenas.
Rev Med Chil, 133 (2005), pp. 439-446
[11.]
D. Berg, M. Asgari.
Evidence-Based Medicine for dermatologic surgeons: concepts in critical appraisal of information.
Dermatol Surg, 27 (2001), pp. 511-514
[12.]
J.J. Manríquez, S. Silva.
Dermatología basada en la evidencia:importancia y conceptos generales.
Piel, 21 (2006), pp. 118-123
[13.]
S.W. Dill, J.J. Digiovanna.
Changing paradigms in dermatology: information technology.
Clin Dermatol, 21 (2003), pp. 375-382
[14.]
B. Pollock, V. Goulden, R. Sheehan-Dare, M. Goodfield.
Dermatology and the World Wide Web.
Br J Dermatol, 144 (2001), pp. 914-915
[15.]
D.A. Barzilai, R. Mikkilineni, B.R. Davis, S.R. Stevens, E.N. Mostow.
Implementation of dermato-epidemiology curriculum at Case Western Reserve University dermatology program.
Dermatol Online J, 10 (2004), pp. 1
[16.]
C. Sitaru.
Dermatology resources on the Internet: a practical guide for dermatologists.
Int J Dermatol, 37 (1998), pp. 641-647
[17.]
M. Bigby.
Evidence-based medicine in a nutshell. A guide to finding and using the best evidence in caring for patients.
Arch Dermatol, 134 (1998), pp. 1609-1618
[18.]
Cochrane Skin Group Website [serial online] [cited May 10, 2008]. Available from: http://www.nottingham.ac.uk/∼muzd/about/reviews.htm
[19.]
A. Collier, K.R. Johnson, F. Delamere, T. Leonard, R.P. Dellavalle, H. Williams.
The Cochrane Skin Group: promoting the best evidence.
J Cutan Med Surg, 9 (2005), pp. 324-331
[20.]
J.J. Manríquez, P. Uribe.
Seborrhoeic Dermatitis.
Clin Evid. BMJ Publishing Group, (2006),
[21.]
R.B. Haynes, N. Wilczynski.
Finding the gold in MEDLINE: clinical queries.
ACP J Club, 142 (2005), pp. A8-A9
[22.]
N.L. Wilczynski, K.A. McKibbon, R.B. Haynes.
Enhancing retrieval of best evidence for health care from bibliographic databases: calibration of the hand search of the literature.
Medinfo, 84 (2001), pp. 390-393
[23.]
N.C. Wilczynski, R.B. Haynes, For the HEDGES Study Team.
Robustness of empirical search strategies for clinical content in MEDLINE.
Proc AMIA Annu Symp, (2002), pp. 904-908
[24.]
D.G. Altman, K.F. Schulz, D. Moher, M. Egger, F. Davidoff, D. Elbourne, et al.
The revised CONSORT statement for reporting randomized trials: explanation and elaboration.
Ann Intern Med, 134 (2001), pp. 663-694
[25.]
P.M. Bossuyt, J.B. Reitsma, D.E. Bruns, C.A. Gatsonis, P.P. Glasziou, L.M. Irwig, et al.
Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD Initiative.
Clin Chem, 49 (2003), pp. 1-6
[26.]
D. Moher, D.J. Cook, S. Eastwood, I. Olkin, D. Rennie, D.F. Stroup.
Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Quality of reporting of meta-analyses.
Lancet, 354 (1999), pp. 1896-1900
[27.]
J.J. Manríquez.
A highly sensitive search strategy for clinical trials in Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS) was developed.
J Clin Epidemiol, 61 (2008), pp. 407-411
[28.]
L.M. Letelier, J.J. Manríquez, J.C. Claro.
El «ciego» en los ensayos clínicos. ¿Importa?.
Rev Med Chil, 132 (2004), pp. 1137-1139
[29.]
L.M. Letelier, J.J. Manríquez, G. Rada.
Revisiones sistemáticas y metaanálisis: ¿son la mejor evidencia?.
Rev Med Chil, 133 (2005), pp. 246-249
[30.]
J.J. Manríquez, F. Villouta, H. Williams.
Evidence based dermatology: Number needed to treat and it relation to other risk measures.
J Am Acad Dermatol, 56 (2007), pp. 664-671
[31.]
H.C. Williams.
Applying trial evidence back to the patient.
Arch Dermatol, 139 (2003), pp. 1195-1200
[32.]
J.J. Manríquez, S. Silva.
Dermatología basada en evidencia:estudios diagnósticos.
Piel, 21 (2006), pp. 371-378
[33.]
J.J. Manríquez, E. Avello, A. Ilabaca, S. Silva.
Análisis crítico de estudios sobre exámenes diagnósticos en dermatología.
Piel, 22 (2007), pp. 45-52
[34.]
Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Medicina basada en la evidencia. Cómo practicar yenseñar la MBE. In: Sackett DL, Straus SE, RichardsonWS, Rosenberg W, Haynes RB, editores. 2.ª ed. Madrid: Harcourt; 2000. p. 57-81.
[35.]
M. Bigby.
Evidence-based dermatology section welcomes anew feature: critically appraised topic.
Arch Dermatol, 143 (2007), pp. 1185-1186
[36.]
Ebderm. Cat Bank [serial online] [cited May 10, 2008]. Available from: http://208.106.170.94/CAT_List.aspx
[37.]
Centre for Evidence Based Medicine. CATmaker [serial online] [cited May 10, 2008]. Available from: http://www.cebm.net/index.aspx?o=1216
Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
Descargar PDF
Idiomas
Actas Dermo-Sifiliográficas
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?