What is the point of databases of reviews for dermatology if all they compile is "insufficient evidence"?

被引:13
作者
Parker, ER
Schilling, LM
Diba, V
Williams, HC
Dellavalle, RP
机构
[1] Univ Colorado, Hlth Sci Ctr, Sch Med, Dept Dermatol, Denver, CO 80262 USA
[2] Vet Affairs Med Ctr, Denver, CO USA
[3] Univ Colorado, Sch Med, Dept Med, Denver, CO 80262 USA
[4] Univ Colorado, Sch Med, Dept Prevent Med & Biometr, Denver, CO 80262 USA
[5] Queens Med Ctr, Ctr Evidence Based Dermatol, Nottingham NG7 2UH, England
关键词
D O I
10.1016/S0190-9622(03)00883-1
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: The use of review databases for dermatology has been questioned because of the impression that these reviews frequently report finding insufficient evidence to guide therapeutic recommendations. Objective. We sought to determine the number of review database entries most relevant to dermatology (addressing diseases with skin manifestations whereby a dermatologist may he the primary caregiver) and the percentage of these entries that report Sufficient evidence to guide clinical decision making. Methods: We conducted computerized searches and analysis of reviews in the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness. Database entries were categorized using the face value reports of the original reviewers as: (1) finding sufficient evidence to inform clinical decisions; (2) finding insufficient evidence; or (3) unable to classify with regard to degree of evidence found. Results: Of all review database entries, 3% (54/1235 in Cochrane Database of Systematic Reviews and 65/2208 in the Database of Abstracts of Reviews of Effectiveness) were deemed relevant to dermatology. in all, 14 entries from the Database of Abstracts of Reviews of Effectiveness were in the process of being written and not available for further evaluation. Of the remaining entries, 40% (42/105) reported finding sufficient evidence. Of the 10 most common dermatologic diagnoses, 8 were addressed in 30% (31/105) of these reviews. Of entries addressing common dermatologic diagnoses, 32% (10/31) reported finding sufficient evidence. Conclusions: Although few (3%) entries in review databases Currently address dermatology topics, entries address many (8/10) of the top 10 dermatology diagnoses. Contrary to popular belief, a substantial number (40%) of such reviews report sufficient evidence to inform clinical decisions making.
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收藏
页码:635 / 639
页数:5
相关论文
共 20 条
[1]   STATISTICS NOTES - ABSENCE OF EVIDENCE IS NOT EVIDENCE OF ABSENCE [J].
ALTMAN, DG ;
BLAND, JM .
BRITISH MEDICAL JOURNAL, 1995, 311 (7003) :485-485
[2]  
[Anonymous], COCHRANE DATABASE SY
[3]   Teaching evidence-based medicine skills to medical students and residents [J].
Barnett, SH ;
Smith, LG ;
Swartz, MH .
INTERNATIONAL JOURNAL OF DERMATOLOGY, 1999, 38 (12) :893-894
[4]   Evidence-based medicine in a nutshell - A guide to finding and using the best evidence in caring for patients [J].
Bigby, M .
ARCHIVES OF DERMATOLOGY, 1998, 134 (12) :1609-1618
[5]   Evidence-based medicine in dermatology [J].
Bigby, M .
DERMATOLOGIC CLINICS, 2000, 18 (02) :261-+
[6]  
Delamere FM, 2001, ARCH DERMATOL, V137, P332
[7]   Assessing evidence-based dermatology and evidence-based internal medicine curricula in US residency training programs - A national survey [J].
Dellavalle, RP ;
Stegner, DL ;
Deas, AM ;
Hester, EJ ;
McCeney, MH ;
Crane, LA ;
Schilling, LM .
ARCHIVES OF DERMATOLOGY, 2003, 139 (03) :369-372
[8]   Most common dermatologic problems identified by internists, 1990-1994 [J].
Feldman, SR ;
Fleischer, AB ;
McConnell, RC .
ARCHIVES OF INTERNAL MEDICINE, 1998, 158 (07) :726-730
[9]   Losing touch with the healing art: Dermatology and the decline of pastoral doctoring [J].
Gibbs, S .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2000, 43 (05) :875-878
[10]   USERS GUIDES TO THE MEDICAL LITERATURE .9. A METHOD FOR GRADING HEALTH-CARE RECOMMENDATIONS [J].
GUYATT, GH ;
SACKETT, DL ;
SINCLAIR, JC ;
HAYWARD, R ;
COOK, DJ ;
COOK, RJ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1995, 274 (22) :1800-1804