Critical Analysis of Asthma Guidelines: Are They Really Evidence-Based?

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"tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "86" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gustavo J. Rodrigo" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Gustavo J." "apellidos" => "Rodrigo" "email" => array:1 [ 0 => "gurodrig@adinet.com.uy" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Emergencia, Hospital Central de las Fuerzas Armadas, Montevideo, Facultad de Medicina, Centro Latinoamericano de Economía Humana del Uruguay (CLAEH), Punta del Este, Uruguay" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dr GJ Rodrigo Departamento de Emergencia, Hospital Central de las Fuerzas Armadas Avda. 8 de Octubre 3.02011600 Montevideo, Uruguay" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-05-10" "fechaAceptado" => "2007-05-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155158" "palabras" => array:5 [ 0 => "Guidelines" 1 => "Consensus" 2 => "Asthma" 3 => "Evidence-based medicine" 4 => "Therapeutics" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155159" "palabras" => array:5 [ 0 => "Guías" 1 => "Consensos" 2 => "Asma" 3 => "Medicina basada en la evidencia" 4 => "Tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "Recent years have seen a growing reliance on “evidence-based” guidelines or consensus statements, in which rigorous, explicit methods are used to translate the complex findings of scientific research into operational recommendations for medical care. Various factors can affect the validity of the conclusions they express, however. The purpose of this review was to compare the levels of evidence supporting treatments for acute asthma in adults according to 3 of the most important guidelines. It seems that even though these guidelines are based on an approach that is more or less rigorous, there are considerable gaps and inconsistencies that compromise their validity. Our main sources of information should therefore be those that apply the best research designs, namely randomized controlled trials or meta-analyses of such trials with consistent results and a low probability of bias." ] "es" => array:1 [ "resumen" => "En los últimos años se ha producido un movimiento creciente hacia el uso de métodos explícitos y rigurosos que conduzcan al desarrollo de guías o consensos “basados en la evidencia”, capaces de convertir los complejos hallazgos de la investigación científica en recomendaciones operativas del cuidado médico. Sin embargo, diferentes factores son potencialmente capaces de afectar a la validez de sus conclusiones. El objetivo de esta revisión consistió en realizar un análisis comparativo de los niveles de evidencia asignados a los tratamientos del asma aguda en el adulto en 3 de las guías más importantes sobre asma. Se puede concluir que, a pesar de que estas guías se desarrollaron con una metodología más o menos rigurosa, presentan importantes carencias o incongruencias que pueden comprometer su validez. En consecuencia, nuestras fuentes prioritarias de información deben ser las de mayor calidad metodológica, es decir, los ensayos aleatorizados y controlados o los metaanálisis de ensayos aleatorizados y controlados con resultados consistentes y baja probabilidad de sesgo." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:2 [ "titulo" => "Clinical practice guidelines: directions for a new program" "serieFecha" => "1990" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical guidelines. 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