Reflexiones sobre la medicina basada en la evidencia aplicada a la cirugía
DOI:
https://doi.org/10.30944/20117582.368Palabras clave:
cirugía general, medicina basada en la evidencia, ensayo clínico controlado aleatorio, investigación aplicadaResumen
Las siguientes reflexiones son personales, basadas en un amplio estudio relacionado con mi especialidad médica y experiencia profesional. No son una crítica abierta y sin fundamento a la medicina basada en la evidencia, de la cual estoy convencido de los grandes aportes que ha traído a la práctica médica. Mucho menos trato de desvirtuar el valor esencial que trae consigo la lectura responsable y constante de los estudiantes y profesionales médicos.
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Referencias bibliográficas
1. Guyatt G, Cairns J, Churchill D, CooK D, Haynes B, Hirsh J, et al. Evidence-Based Medicine, a new approach to teaching the practice of medicine. JAMA. 1992;268:2420-5.
https://doi.org/10.1001/jama.1992.03490170092032
2. Loannidis J. Why most published research findings are false. PLoS Med. 2005;2:e124.
https://doi.org/10.1371/journal.pmed.0020124
3. Greenhalgh T. Why do we always end up here? Evidence- based medicine's conceptual cul-de-sacs and some off-road alternative routes. J Prim Health Care. 2012;4:92-7.
https://doi.org/10.1071/HC12092
4. Majeed A, Ferguson J, Field J. Prescribing of beta-2 agonists and inhaled steroids in England: Trends between 1992 and 1998, and association with material deprivation, chronic illness and asthma mortality rates. J Public Health. 1999;21:395-400.
https://doi.org/10.1093/pubmed/21.4.395
5. Lau B, Haut E. Practices to prevent venous thromboembolism: A brief review. BMJ Qual Saf. 2014;23:187-95.
https://doi.org/10.1136/bmjqs-2012-001782
6. Every-Palmer S, Howick J. How evidence-based medicine is failing due to biased trials and selective publication. J Eval Clin Pract. 2014;20:908-14.
https://doi.org/10.1111/jep.12147
7. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 2008;358:252-60.
https://doi.org/10.1056/NEJMsa065779
8. Allen D, Harkins KJ. Too much guidance? Lancet. 2005;365:1768.
https://doi.org/10.1016/S0140-6736(05)66578-6
9. Moynihan R, Doust J, Henry D. Preventing overdiagnosis: How to stop harming the healthy. BMJ. 2012;344:e3502.
https://doi.org/10.1136/bmj.e3502
10. Choosing Wisely. Fecha de consulta: 20 de febrero, 2015. Disponible en: http://www.choosingwisely.org.
11. Cohen D. FDA official: "Clinical trial system is broken" BMJ. 2013;347:f6980.
https://doi.org/10.1136/bmj.f6980
12. Cohen D. Rosiglitazone: What went wrong? BMJ. 2010;341:c4848.
https://doi.org/10.1136/bmj.c4848
13. Eyding D, Lelgemann M, Grouven U, Härter M, Kromp M, Kaiser T, et al. Reboxetine for acute treatment of major depression: Systematic review and meta-analysis of published and unpublished placebo and selective serotonin reuptake inhibitors controlled trials. BMJ. 2010;341:4737-41.
https://doi.org/10.1136/bmj.c4737
14. Gotzsche P, Hróbjartsson A, Johansen HK, Haahr MT, Altman DG, Chan AW. Ghost authorship in industry-initiated randomised trials. Plos Medicine 2007;4:47-52.
https://doi.org/10.1371/journal.pmed.0040019
15. Scientific misconduct blog. Fecha de consulta: 20 de febrero de 2015. Disponible en: http://www.webring.org/l/rd?ring=antiqua ckerysite;id=48;url=http%3A%2F%2Fscientific-misconduct%2 Eblogspot%2Ecom%2Ees%2F.
16. Times Higher Education. Eastell suspended as finances are queried. Fecha de consulta: 20 de febrero de 2015. Disponible en: https://www.timeshighereducation.co.uk/news/eastellsuspended-as-finances-are-queried/196007.article.
17. Adam R, De Gramont A, Figueras J, Guthrie A, Kokudo N, Kunstlinger F, et al. The oncosurgery approach to managing liver metastasis from colorectal cáncer: A multidisciplinary international consensus. The Oncologist. 2012;17:1225-39.
https://doi.org/10.1634/theoncologist.2012-0121
18. Wang A, McCoy C, Murad MH, Montori V. Association between industry affiliation and position on cardiovascular risk with rosiglitazone: Cross sectional systematic review. BMJ. 2010;340:1344-8.
https://doi.org/10.1136/bmj.c1344
19. Urbach D. Surgical outcome research. XXXIV Congreso Nacional "Avances en Cirugía", Bogotá, agosto de 2008.
20. El-Serag H, Talwalkar J, Kim WR. Efficacy, effectiveness, and comparative effectiveness in liver disease. Hepatology. 2010;52:403-7.
https://doi.org/10.1002/hep.23819
21. Singal A, Higgins P, Waljee A. A primer on effectiveness and efficacy trials. Clin Transl Gastroenterol. 2014;5:e45.
https://doi.org/10.1038/ctg.2013.13
22. Peng SY, Wang JW, Lau WY, Cai XJ, Mou YP, Liu YB, et al. Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy. A prospective randomized trial. Ann Surg. 2007;245:692-8.
https://doi.org/10.1097/01.sla.0000255588.50964.5d
23. Maggiory L, Sauvanet A, Nagarajan G, Dokma KS, Aussilhou B, Belghiti J. Binding versus conventional pancreaticojejunostomy after pancreaticoduodenectomy: A case matched study. J Gastrointest Surg. 2010;14:1395-400.
https://doi.org/10.1007/s11605-010-1212-0
24. Buc E, Flamein R, Golffier C, Dubois A, Nagarajan G, Futier E, et al. Peng's binding pancreaticojejunostomy after pancreaticoduodenectomy: A French prospective study. J Gastrointest Surg. 2010;14:705-10.
https://doi.org/10.1007/s11605-009-1125-y
25. Mentha G, Majno PE, Andres A, Rubbia-Brandt L, Morel P, Roth AD. Neoadjuvant chemotherapy and resection of advanced synchronous liver metastases before treatment of the colorectal primary. Br J Sur. 2006;93:872-8.
https://doi.org/10.1002/bjs.5346
26. Brouquet A, Mortenson M, Vauthey JN, Rodríguez-Bigas M, Overman M, Chang G, et al. Surgical strategies for synchronous colorectal liver metastases in 156 consecutive patients: Classic, combined or reverse strategy? J Am Coll Surg. 2010;210:934-41.
https://doi.org/10.1016/j.jamcollsurg.2010.02.039
27. Kelly ME, Spolverato G, Le GN, Mavros MN, Doyle F, Pawlik TM, et al. Synchronous colorectal liver metastasis: A network meta-analysis review comparing classical, combined, and liverfirst surgical strategies. J Surg Oncol, 2015;111:341-51.
https://doi.org/10.1002/jso.23819
28. Lee SG. A complete treatment of adult living donor liver transplantation: A review of surgical technique and current challenges to expand indication of patients. Am J Transpl. 2015;15:17-38.
https://doi.org/10.1111/ajt.12907
29. ILCA Symposium 2: Clinical controversies in liver cancer (pros and cons session). Resection should be performed according to BCLC. Josep Fuster, MD (Spain) vs. Ronnie Poon, MD, PhD (P. R. China). ILCA 8th Annual Conference, September 5-7, 2014. Kyoto, Japan.
30. Cameron J, Riall T, Coleman J, Belcher K. One thousand consecutive pancreaticoduodenectomies. Ann Surg. 2006;244:10-5.
https://doi.org/10.1097/01.sla.0000217673.04165.ea
31. Fernández-del Castillo C, Morales-Ayarvide V, McGrath D, Wargo J, Ferrone C, Thayer S, et al. Evolution of the Whipple procedure at the Massachusetts General Hospital. Surgery. 2012;152:s56-63.
https://doi.org/10.1016/j.surg.2012.05.022
32. Hoyos S, Guzmán C. Resultados de duodenopancreatectomía cefálica en el Hospital Pablo Tobón Uribe de Medellín, en un período de tres años. Rev Colomb Cir. 2008;23:12-5.
33. Hoyos S, Duarte A, Chávez J, Franco G, Gómez S, Sánchez J. Evaluación y seguimiento de los pacientes sometidos a operación de Whipple o duodenopancreatectomía cefálica, en un hospital de IV nivel de Medellín. Rev Colomb Cir. 2012;27:114-20.
34. Chávez J, Hoyos S, Duarte A, Ángel C, Segura A. Análisis de la mortalidad posoperatoria temprana en una cohorte de 132 pacientes sometidos a cirugía de Whipple en Medellín. Rev Colomb Cir. 2014;29:123-30.
35. Trede M, Schwall G, Saeger HD. Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg. 1990;211:447-58.
https://doi.org/10.1097/00000658-199004000-00011
36. Böttger TC, Junginger T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: Critical analysis of 221 resections. World J Surg. 1999;23:164-71.
https://doi.org/10.1007/PL00013170
37. Balcom JH, Rattner DW, Warshaw AL, Chang Y, Fernández-del Castillo C. Ten-year experience with 733 pancreatic resections: Changing indications, older patients, and decreasing length of hospitalization. Arch Surg. 2001;136:391-8.
https://doi.org/10.1001/archsurg.136.4.391
38. Büchler MW, Wagner M, Schmied BM, Uhl U, Friess H,Z'graggen K. Changes in morbidity after pancreatic resection: Toward the end of completion pancreatectomy. Arch Surg. 2003;138:1310-4.
https://doi.org/10.1001/archsurg.138.12.1310
39. Aranha GV, Hodul PJ, Creech S, Jacobs W. Zero mortality after 152 consecutive pancreatoduodenectomies with pancreaticogastrostomy. J Am Coll Surg. 2003;197:223-31.
https://doi.org/10.1016/S1072-7515(03)00331-4
40. Qiao QL, Zhao YG, Ye ML, Yang YM, Zhao JX, Huang YT, et al. Carcinoma of the ampulla of Vater: Factors influencing long-term survival of 127 patients with resection. World J Surg. 2007;31:137-46.
https://doi.org/10.1007/s00268-006-0213-3
41. Sanabria A, Castañeda M. Calidad en cirugía: ¿qué hace al mejor cirujano del país? Rev Colomb Cir. 2014;29:7-11.
42. Patiño JF. ¿Existe la cirugía basada en la evidencia? Rev Colomb Cir. 2014;29:262-8.
https://doi.org/10.1001/jama.1992.03490170092032
2. Loannidis J. Why most published research findings are false. PLoS Med. 2005;2:e124.
https://doi.org/10.1371/journal.pmed.0020124
3. Greenhalgh T. Why do we always end up here? Evidence- based medicine's conceptual cul-de-sacs and some off-road alternative routes. J Prim Health Care. 2012;4:92-7.
https://doi.org/10.1071/HC12092
4. Majeed A, Ferguson J, Field J. Prescribing of beta-2 agonists and inhaled steroids in England: Trends between 1992 and 1998, and association with material deprivation, chronic illness and asthma mortality rates. J Public Health. 1999;21:395-400.
https://doi.org/10.1093/pubmed/21.4.395
5. Lau B, Haut E. Practices to prevent venous thromboembolism: A brief review. BMJ Qual Saf. 2014;23:187-95.
https://doi.org/10.1136/bmjqs-2012-001782
6. Every-Palmer S, Howick J. How evidence-based medicine is failing due to biased trials and selective publication. J Eval Clin Pract. 2014;20:908-14.
https://doi.org/10.1111/jep.12147
7. Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 2008;358:252-60.
https://doi.org/10.1056/NEJMsa065779
8. Allen D, Harkins KJ. Too much guidance? Lancet. 2005;365:1768.
https://doi.org/10.1016/S0140-6736(05)66578-6
9. Moynihan R, Doust J, Henry D. Preventing overdiagnosis: How to stop harming the healthy. BMJ. 2012;344:e3502.
https://doi.org/10.1136/bmj.e3502
10. Choosing Wisely. Fecha de consulta: 20 de febrero, 2015. Disponible en: http://www.choosingwisely.org.
11. Cohen D. FDA official: "Clinical trial system is broken" BMJ. 2013;347:f6980.
https://doi.org/10.1136/bmj.f6980
12. Cohen D. Rosiglitazone: What went wrong? BMJ. 2010;341:c4848.
https://doi.org/10.1136/bmj.c4848
13. Eyding D, Lelgemann M, Grouven U, Härter M, Kromp M, Kaiser T, et al. Reboxetine for acute treatment of major depression: Systematic review and meta-analysis of published and unpublished placebo and selective serotonin reuptake inhibitors controlled trials. BMJ. 2010;341:4737-41.
https://doi.org/10.1136/bmj.c4737
14. Gotzsche P, Hróbjartsson A, Johansen HK, Haahr MT, Altman DG, Chan AW. Ghost authorship in industry-initiated randomised trials. Plos Medicine 2007;4:47-52.
https://doi.org/10.1371/journal.pmed.0040019
15. Scientific misconduct blog. Fecha de consulta: 20 de febrero de 2015. Disponible en: http://www.webring.org/l/rd?ring=antiqua ckerysite;id=48;url=http%3A%2F%2Fscientific-misconduct%2 Eblogspot%2Ecom%2Ees%2F.
16. Times Higher Education. Eastell suspended as finances are queried. Fecha de consulta: 20 de febrero de 2015. Disponible en: https://www.timeshighereducation.co.uk/news/eastellsuspended-as-finances-are-queried/196007.article.
17. Adam R, De Gramont A, Figueras J, Guthrie A, Kokudo N, Kunstlinger F, et al. The oncosurgery approach to managing liver metastasis from colorectal cáncer: A multidisciplinary international consensus. The Oncologist. 2012;17:1225-39.
https://doi.org/10.1634/theoncologist.2012-0121
18. Wang A, McCoy C, Murad MH, Montori V. Association between industry affiliation and position on cardiovascular risk with rosiglitazone: Cross sectional systematic review. BMJ. 2010;340:1344-8.
https://doi.org/10.1136/bmj.c1344
19. Urbach D. Surgical outcome research. XXXIV Congreso Nacional "Avances en Cirugía", Bogotá, agosto de 2008.
20. El-Serag H, Talwalkar J, Kim WR. Efficacy, effectiveness, and comparative effectiveness in liver disease. Hepatology. 2010;52:403-7.
https://doi.org/10.1002/hep.23819
21. Singal A, Higgins P, Waljee A. A primer on effectiveness and efficacy trials. Clin Transl Gastroenterol. 2014;5:e45.
https://doi.org/10.1038/ctg.2013.13
22. Peng SY, Wang JW, Lau WY, Cai XJ, Mou YP, Liu YB, et al. Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy. A prospective randomized trial. Ann Surg. 2007;245:692-8.
https://doi.org/10.1097/01.sla.0000255588.50964.5d
23. Maggiory L, Sauvanet A, Nagarajan G, Dokma KS, Aussilhou B, Belghiti J. Binding versus conventional pancreaticojejunostomy after pancreaticoduodenectomy: A case matched study. J Gastrointest Surg. 2010;14:1395-400.
https://doi.org/10.1007/s11605-010-1212-0
24. Buc E, Flamein R, Golffier C, Dubois A, Nagarajan G, Futier E, et al. Peng's binding pancreaticojejunostomy after pancreaticoduodenectomy: A French prospective study. J Gastrointest Surg. 2010;14:705-10.
https://doi.org/10.1007/s11605-009-1125-y
25. Mentha G, Majno PE, Andres A, Rubbia-Brandt L, Morel P, Roth AD. Neoadjuvant chemotherapy and resection of advanced synchronous liver metastases before treatment of the colorectal primary. Br J Sur. 2006;93:872-8.
https://doi.org/10.1002/bjs.5346
26. Brouquet A, Mortenson M, Vauthey JN, Rodríguez-Bigas M, Overman M, Chang G, et al. Surgical strategies for synchronous colorectal liver metastases in 156 consecutive patients: Classic, combined or reverse strategy? J Am Coll Surg. 2010;210:934-41.
https://doi.org/10.1016/j.jamcollsurg.2010.02.039
27. Kelly ME, Spolverato G, Le GN, Mavros MN, Doyle F, Pawlik TM, et al. Synchronous colorectal liver metastasis: A network meta-analysis review comparing classical, combined, and liverfirst surgical strategies. J Surg Oncol, 2015;111:341-51.
https://doi.org/10.1002/jso.23819
28. Lee SG. A complete treatment of adult living donor liver transplantation: A review of surgical technique and current challenges to expand indication of patients. Am J Transpl. 2015;15:17-38.
https://doi.org/10.1111/ajt.12907
29. ILCA Symposium 2: Clinical controversies in liver cancer (pros and cons session). Resection should be performed according to BCLC. Josep Fuster, MD (Spain) vs. Ronnie Poon, MD, PhD (P. R. China). ILCA 8th Annual Conference, September 5-7, 2014. Kyoto, Japan.
30. Cameron J, Riall T, Coleman J, Belcher K. One thousand consecutive pancreaticoduodenectomies. Ann Surg. 2006;244:10-5.
https://doi.org/10.1097/01.sla.0000217673.04165.ea
31. Fernández-del Castillo C, Morales-Ayarvide V, McGrath D, Wargo J, Ferrone C, Thayer S, et al. Evolution of the Whipple procedure at the Massachusetts General Hospital. Surgery. 2012;152:s56-63.
https://doi.org/10.1016/j.surg.2012.05.022
32. Hoyos S, Guzmán C. Resultados de duodenopancreatectomía cefálica en el Hospital Pablo Tobón Uribe de Medellín, en un período de tres años. Rev Colomb Cir. 2008;23:12-5.
33. Hoyos S, Duarte A, Chávez J, Franco G, Gómez S, Sánchez J. Evaluación y seguimiento de los pacientes sometidos a operación de Whipple o duodenopancreatectomía cefálica, en un hospital de IV nivel de Medellín. Rev Colomb Cir. 2012;27:114-20.
34. Chávez J, Hoyos S, Duarte A, Ángel C, Segura A. Análisis de la mortalidad posoperatoria temprana en una cohorte de 132 pacientes sometidos a cirugía de Whipple en Medellín. Rev Colomb Cir. 2014;29:123-30.
35. Trede M, Schwall G, Saeger HD. Survival after pancreatoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg. 1990;211:447-58.
https://doi.org/10.1097/00000658-199004000-00011
36. Böttger TC, Junginger T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: Critical analysis of 221 resections. World J Surg. 1999;23:164-71.
https://doi.org/10.1007/PL00013170
37. Balcom JH, Rattner DW, Warshaw AL, Chang Y, Fernández-del Castillo C. Ten-year experience with 733 pancreatic resections: Changing indications, older patients, and decreasing length of hospitalization. Arch Surg. 2001;136:391-8.
https://doi.org/10.1001/archsurg.136.4.391
38. Büchler MW, Wagner M, Schmied BM, Uhl U, Friess H,Z'graggen K. Changes in morbidity after pancreatic resection: Toward the end of completion pancreatectomy. Arch Surg. 2003;138:1310-4.
https://doi.org/10.1001/archsurg.138.12.1310
39. Aranha GV, Hodul PJ, Creech S, Jacobs W. Zero mortality after 152 consecutive pancreatoduodenectomies with pancreaticogastrostomy. J Am Coll Surg. 2003;197:223-31.
https://doi.org/10.1016/S1072-7515(03)00331-4
40. Qiao QL, Zhao YG, Ye ML, Yang YM, Zhao JX, Huang YT, et al. Carcinoma of the ampulla of Vater: Factors influencing long-term survival of 127 patients with resection. World J Surg. 2007;31:137-46.
https://doi.org/10.1007/s00268-006-0213-3
41. Sanabria A, Castañeda M. Calidad en cirugía: ¿qué hace al mejor cirujano del país? Rev Colomb Cir. 2014;29:7-11.
42. Patiño JF. ¿Existe la cirugía basada en la evidencia? Rev Colomb Cir. 2014;29:262-8.
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2015-01-01
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Hoyos, S. . Reflexiones Sobre La Medicina Basada En La Evidencia Aplicada a La cirugía. Rev Colomb Cir 2015, 30, 170-177.
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