Examinando por Autor "Salas-Gama, Karla"

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    Ítem
    Efficacy of systemic oncological treatments in patients with advanced pancreatic cancer at high risk of dying in the short or medium-term: overview of systematic reviews
    (Elsevier, 2021) Salazar, Josefina; Perez-Bracchiglione, Javier; Salas-Gama, Karla; Antequera, Alba; Auladell-Rispau, Ariadna; Dorantes-Romandı, Rosario; Meade, Adriana G.; Quintana, María Jesús; Requeijo, Carolina; Rodrıíguez-Grijalva, Gerardo; Santero, Marilina; Acosta-Dighero, Roberto; Sola, Iván; Urrútia, Gerard; Bonfill Cosp, Xavier
    Background: Patients with advanced pancreatic cancer (PC) have a high risk of dying in the short or medium-term. This overview aimed to assess the evidence regarding systemic oncological treatments (SOT) versus supportive care for advanced PC. Methods: We searched for systematic reviews (SRs) in MEDLINE, Embase, The Cochrane Library, Epistemonikos, and PROSPERO. Two authors assessed eligibility independently. Data extraction and methodological quality assessment were conducted by one author and cross-checked by another one. We evaluated the overlap of primary studies, performed a de novo meta-analysis, and assessed the certainty of evidence. Primary outcomes were overall survival (OS), quality of life (QoL), functional status (FS), and toxicity. Results: We identified three SRs that assessed SOT versus supportive care in patients with advanced PC. All SRs had critically low methodological quality. At 12 months, OS improved with chemotherapy, radiotherapy followed by chemotherapy, and immunotherapy, but the certainty of the evidence supporting these findings is very low. The evidence on chemotherapy is very uncertain about its effects on QoL; it suggests a slight increase in toxicity and little to no difference in FS. The evidence on immunotherapy is very uncertain about its effects in toxicity. Conclusions: The identified evidence is very uncertain about the benefits of oncological treatments on OS and QoL in patients with advanced PC with a high risk of dying in the short or medium-term, so its use should be proposed only to selected patients. Further studies that include a thorough assessment of patient-centred outcomes are needed.
  • Miniatura
    Ítem
    Patient decision aids for adults with advanced chronic kidney disease with a medical recommendation to start dialysis: a scoping review protocol
    (JBI, 2021) Salas-Gama, Karla; Díaz, Juan Manuel; Coronado, Jorge; Pérez-Bracchiglione, Javier; Requeijo, Carolina; Samsó, Laura; Suclupe, Stefanie; Bolíbar, Ignasi
    Objective: This review will identify and describe the content and assess the quality of available decision aids aimed at adults with advanced chronic kidney disease with medical indication to start dialysis who need to choose one of the two dialysis modalities. Introduction: The lack of evidence regarding the superiority of the different options for dialysis, hemodialysis, and peritoneal dialysis, indicated in advanced chronic kidney disease, makes the shared decision-making process especially important. Inclusion criteria: We will include decision aids from published studies and non-published material aimed at adults with advanced chronic kidney disease. Methods: We will perform searches in MEDLINE, CINAHL, Embase, PsycINFO, the Cochrane Library, and Epistemonikos. In addition, we will search unpublished studies in OpenGrey, ClinicalTrials.gov, and Open Access Theses and Dissertations. We will also identify decision aids through a specific search in Google and by searching websites of nephrology societies or associations. We will include decision aids in English or Spanish aimed at adults with advanced chronic kidney disease with medical indication to start dialysis. Two independent reviewers will screen, select, and extract the data. General aspects and attributes of the decision aids will be collected. Their quality will be evaluated, and their recommendations for implementation in clinical practice will be analyzed.
  • Miniatura
    Ítem
    The perspectives of patients and their caregivers on self-management interventions for chronic conditions: a protocol for a mixed-methods overview [version 2,peer review: 2 approved]
    (2021) Niño De Guzmán, Ena; Martínez García, Laura; González, Ana I.; Heijmans, Monique; Huaringa, Jorge; Immonen, Kaisa; Ninov, Lyudmil; Orrego-Villagrán, Carola; Pérez-Bracchiglione, Javier; Salas-Gama, Karla; Viteri-García, Andrés; Alonso-Coello, Pablo
    Introduction: Self-management (SM) interventions are complex interventions and one of the main components of high-quality chronic disease care for which the incorporation of the perspectives of patients and their informal caregivers is crucial. We aim to identify, appraise and synthesise the evidence exploring patients’ and caregivers’ perspectives on SM interventions. More precisely, we aim to 1) describe how they value the importance of outcomes of SM interventions, and 2) identify the factors that might impact on acceptability and feasibility of SM interventions based on their preferences and experiences. Methods and analysis: We will conduct four mixed-methods overviews as part of COMPAR-EU, a European Union (EU) funded project aimed to identify the most effective and cost-effective SM interventions for chronic obstructive pulmonary disease (COPD), heart failure (HF), obesity, and type 2 diabetes mellitus (T2DM). We will search in MEDLINE, CINAHL, and PsycINFO for systematic reviews of studies addressing patients’ preferences on outcomes, or their experiences with SM alongside their disease trajectory or with SM interventions, published in English. Selection of studies and data extraction will be conducted in pairs. We will assess the overlap of studies and methodological quality. We will follow a three-step synthesis process: 1) narrative synthesis for quantitative evidence, 2) thematic synthesis for qualitative evidence, and 3) integration of findings in the interpretation phase. Additionally, we will consult on the relevance of findings with patients and their caregivers.